| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $149.47 | $150.99 | $160.30 | |
Cigna
| Professional | $87.87 | $87.87 | $87.87 | |
Providence
| Facility | $116.43 | $149.72 | $205.03 | |
Providence
| Professional | $87.87 | $160.30 | $10,000.00 | |
United
| Professional | $82.54 | $91.33 | $131.02 |