| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $346.55 | $346.55 | $346.55 | |
Cigna
| Facility | $436.96 | $436.96 | $436.96 | |
Cigna
| Professional | $436.96 | $436.96 | $436.96 | |
Providence
| Facility | $436.96 | $436.96 | $436.96 | |
Providence
| Professional | $271.22 | $271.22 | $436.96 | |
United
| Professional | $126.57 | $126.57 | $301.35 |