| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $146.84 | $147.63 | $148.34 | |
Cigna
| Professional | $80.93 | $80.93 | $80.93 | |
Providence
| Facility | $95.75 | $123.13 | $168.60 | |
Providence
| Professional | $80.93 | $157.47 | $10,000.00 | |
United
| Professional | $76.02 | $84.11 | $120.67 |