| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $371.40 | $371.40 | $371.40 | |
Cigna
| Facility | $468.29 | $468.29 | $468.29 | |
Cigna
| Professional | $370.87 | $463.59 | $468.29 | |
Providence
| Facility | $468.29 | $468.29 | $468.29 | |
Providence
| Professional | $290.66 | $322.95 | $403.70 | |
United
| Professional | $135.63 | $135.63 | $358.85 |