| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $91.59 | $92.53 | $98.25 | |
Cigna
| Professional | $49.92 | $49.92 | $49.92 | |
Providence
| Facility | $59.08 | $75.95 | $104.01 | |
Providence
| Professional | $49.92 | $98.23 | $10,000.00 | |
United
| Professional | $46.90 | $51.89 | $74.44 |