| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $761.67 | $761.67 | $761.67 | |
Cigna
| Facility | $960.36 | $960.36 | $960.36 | |
Cigna
| Professional | $960.36 | $960.36 | $960.36 | |
Providence
| Facility | $960.36 | $960.36 | $960.36 | |
Providence
| Professional | $794.78 | $794.78 | $960.36 | |
United
| Professional | $278.17 | $278.17 | $662.32 |