| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $121.32 | $122.56 | $130.12 | |
Cigna
| Professional | $71.33 | $71.33 | $71.33 | |
Providence
| Facility | $99.82 | $129.97 | $181.59 | |
Providence
| Professional | $71.33 | $130.12 | $10,000.00 | |
United
| Professional | $67.00 | $74.14 | $123.56 |