| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,960.85 | $2,960.85 | $2,960.85 | |
Cigna
| Facility | $3,733.24 | $3,733.24 | $3,733.24 | |
Cigna
| Professional | $3,733.24 | $3,733.24 | $3,733.24 | |
Providence
| Facility | $3,733.24 | $3,733.24 | $3,733.24 | |
Providence
| Professional | $2,317.19 | $2,317.19 | $3,733.24 | |
United
| Professional | $1,081.34 | $1,081.34 | $2,574.65 |