| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $413.79 | $428.51 | $428.51 | |
Cigna
| Facility | $555.77 | $555.77 | $555.77 | |
Cigna
| Professional | $472.40 | $500.19 | $555.77 | |
Providence
| Facility | $224.08 | $224.08 | $555.77 | |
Providence
| Professional | $472.40 | $555.77 | $852.99 | |
United
| Professional | $402.90 | $469.39 | $548.04 |