| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $973.21 | $973.21 | $973.21 | |
Cigna
| Facility | $1,227.08 | $1,227.08 | $1,227.08 | |
Cigna
| Professional | $1,227.08 | $1,227.08 | $1,227.08 | |
Providence
| Facility | $1,227.08 | $1,227.08 | $1,227.08 | |
Providence
| Professional | $761.64 | $761.64 | $1,227.08 | |
United
| Professional | $355.43 | $355.43 | $846.27 |