| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $966.75 | $966.75 | $966.75 | |
Cigna
| Facility | $1,218.94 | $1,218.94 | $1,218.94 | |
Cigna
| Professional | $966.01 | $1,207.51 | $1,218.94 | |
Providence
| Facility | $1,218.94 | $1,218.94 | $1,218.94 | |
Providence
| Professional | $756.59 | $840.65 | $1,050.81 | |
United
| Professional | $353.07 | $353.07 | $840.65 |