| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $119.23 | $120.44 | $125.40 | |
Cigna
| Professional | $68.73 | $68.73 | $68.73 | |
Providence
| Facility | $81.34 | $110.91 | $143.21 | |
Providence
| Professional | $68.73 | $127.86 | $10,000.00 | |
United
| Professional | $64.58 | $71.45 | $119.08 |