| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $57.45 | $57.45 | $62.09 | |
Cigna
| Professional | $14.25 | $14.25 | $14.25 | |
Providence
| Facility | $45.02 | $45.02 | $45.02 | |
Providence
| Professional | $14.25 | $175.00 | $10,000.00 |