| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6,008.29 | $6,008.29 | $6,008.29 | |
Cigna
| Facility | $7,575.67 | $7,575.67 | $7,575.67 | |
Cigna
| Professional | $7,575.67 | $7,575.67 | $7,575.67 | |
Providence
| Facility | $7,575.67 | $7,575.67 | $7,575.67 | |
Providence
| Professional | $4,702.14 | $4,702.14 | $7,575.67 | |
United
| Professional | $2,194.33 | $2,194.33 | $5,224.60 |