| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $672.75 | $1,401.56 | $2,691.00 | |
Aetna
| Professional | $672.75 | $1,121.25 | $1,121.25 | |
Cigna
| Professional | $1,030.84 | $1,030.84 | $1,288.56 | |
Providence
| Facility | $538.20 | $852.15 | $1,121.25 | |
Providence
| Professional | $735.54 | $897.00 | $897.00 | |
United
| Professional | $376.74 | $376.74 | $538.20 |