| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $87.47 | $88.36 | $89.99 | |
Cigna
| Professional | $49.33 | $49.33 | $49.33 | |
Providence
| Facility | $58.37 | $74.62 | $102.78 | |
Providence
| Professional | $49.33 | $93.80 | $10,000.00 | |
United
| Professional | $46.34 | $51.28 | $73.56 |