| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $699.40 | $699.40 | $699.40 | |
Cigna
| Facility | $881.85 | $881.85 | $881.85 | |
Cigna
| Professional | $881.85 | $881.85 | $881.85 | |
Providence
| Facility | $881.85 | $881.85 | $881.85 | |
Providence
| Professional | $729.80 | $760.21 | $881.85 | |
United
| Professional | $255.43 | $255.43 | $608.16 |