| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $578.91 | $578.91 | $578.91 | |
Cigna
| Facility | $729.93 | $729.93 | $729.93 | |
Cigna
| Professional | $578.20 | $722.75 | $729.93 | |
Providence
| Facility | $729.93 | $729.93 | $729.93 | |
Providence
| Professional | $453.06 | $503.40 | $629.25 | |
United
| Professional | $211.43 | $211.43 | $503.40 |