| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,800.25 | $2,800.25 | $2,800.25 | |
Cigna
| Facility | $3,530.75 | $3,530.75 | $3,530.75 | |
Cigna
| Professional | $3,530.75 | $3,530.75 | $3,530.75 | |
Providence
| Facility | $3,530.75 | $3,530.75 | $3,530.75 | |
Providence
| Professional | $2,922.00 | $2,922.00 | $3,530.75 | |
United
| Professional | $1,022.70 | $1,022.70 | $2,435.00 |