| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $431.54 | $431.54 | $431.54 | |
Cigna
| Facility | $544.11 | $544.11 | $544.11 | |
Cigna
| Professional | $544.11 | $544.11 | $544.11 | |
Providence
| Facility | $544.11 | $544.11 | $544.11 | |
Providence
| Professional | $337.73 | $337.73 | $544.11 | |
United
| Professional | $157.61 | $157.61 | $375.25 |