| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $183.94 | $183.94 | $183.94 | |
Cigna
| Facility | $4,581.16 | $4,581.16 | $5,931.88 | |
Cigna
| Professional | $4,581.16 | $4,581.16 | $4,581.16 | |
Providence
| Facility | $4,581.16 | $4,581.16 | $5,931.88 | |
Providence
| Professional | $3,791.30 | $3,949.28 | $4,581.16 | |
United
| Professional | $1,326.96 | $1,326.96 | $3,159.42 |