| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $89.92 | $90.83 | $106.38 | |
Cigna
| Professional | $51.62 | $51.62 | $51.62 | |
Providence
| Facility | $61.08 | $86.24 | $107.55 | |
Providence
| Professional | $51.62 | $96.43 | $10,000.00 | |
United
| Professional | $48.50 | $53.66 | $76.98 |