| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $218.57 | $220.80 | $298.79 | |
Cigna
| Professional | $128.49 | $128.49 | $128.49 | |
Providence
| Facility | $160.97 | $212.78 | $291.33 | |
Providence
| Professional | $128.49 | $234.40 | $10,000.00 | |
United
| Professional | $120.70 | $133.55 | $191.59 |