| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $449.36 | $449.36 | $449.36 | |
Cigna
| Facility | $566.59 | $566.59 | $566.59 | |
Cigna
| Professional | $448.93 | $561.16 | $566.59 | |
Providence
| Facility | $566.59 | $566.59 | $566.59 | |
Providence
| Professional | $351.68 | $351.68 | $566.59 | |
United
| Professional | $164.12 | $164.12 | $390.75 |