| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $114.62 | $132.69 | $239.94 | |
Cigna
| Professional | $60.08 | $60.08 | $60.08 | |
Providence
| Facility | $71.09 | $91.42 | $125.17 | |
Providence
| Professional | $60.08 | $122.92 | $10,000.00 | |
United
| Professional | $56.44 | $62.45 | $94.07 |