| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $108.56 | $109.67 | $128.76 | |
Cigna
| Professional | $62.26 | $62.26 | $62.26 | |
Providence
| Facility | $83.82 | $105.63 | $147.57 | |
Providence
| Professional | $62.26 | $116.43 | $10,000.00 | |
United
| Professional | $58.48 | $64.70 | $92.83 |