| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $585.58 | $585.58 | $585.58 | |
Cigna
| Facility | $738.34 | $738.34 | $738.34 | |
Cigna
| Professional | $585.22 | $731.53 | $738.34 | |
Providence
| Facility | $738.34 | $738.34 | $738.34 | |
Providence
| Professional | $458.28 | $458.28 | $738.34 | |
United
| Professional | $213.86 | $213.86 | $509.20 |