| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $672.64 | $672.64 | $672.64 | |
Cigna
| Facility | $848.11 | $848.11 | $848.11 | |
Cigna
| Professional | $848.11 | $848.11 | $848.11 | |
Providence
| Facility | $848.11 | $848.11 | $848.11 | |
Providence
| Professional | $526.41 | $526.41 | $848.11 | |
United
| Facility | $701.88 | $701.88 | $701.88 | |
United
| Professional | $245.66 | $245.66 | $584.90 |