| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $115.26 | $116.43 | $125.04 | |
Cigna
| Professional | $67.76 | $67.76 | $67.76 | |
Providence
| Facility | $80.17 | $105.23 | $141.16 | |
Providence
| Professional | $67.76 | $123.61 | $10,000.00 | |
United
| Professional | $63.65 | $70.42 | $101.04 |