| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $184.60 | $186.49 | $263.97 | |
Cigna
| Professional | $108.53 | $108.53 | $108.53 | |
Providence
| Facility | $128.41 | $165.13 | $226.10 | |
Providence
| Professional | $108.53 | $197.98 | $10,000.00 | |
United
| Professional | $101.95 | $112.80 | $161.83 |