| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $150.69 | $152.22 | $193.43 | |
Cigna
| Professional | $86.76 | $86.76 | $86.76 | |
Providence
| Facility | $102.65 | $131.99 | $180.74 | |
Providence
| Professional | $86.76 | $161.61 | $10,000.00 | |
United
| Professional | $81.48 | $90.17 | $129.36 |