| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $283.95 | $283.95 | $283.95 | |
Cigna
| Facility | $358.03 | $358.03 | $358.03 | |
Cigna
| Professional | $283.73 | $354.66 | $358.03 | |
Providence
| Facility | $358.03 | $358.03 | $358.03 | |
Providence
| Professional | $222.23 | $222.23 | $358.03 | |
United
| Professional | $103.71 | $103.71 | $246.92 |