| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $57.34 | $57.92 | $63.34 | |
Cigna
| Professional | $30.85 | $30.85 | $30.85 | |
Providence
| Facility | $41.32 | $52.07 | $72.73 | |
Providence
| Professional | $30.85 | $61.49 | $10,000.00 | |
United
| Professional | $28.99 | $32.07 | $46.01 |