| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $377.19 | $377.19 | $377.19 | |
Cigna
| Facility | $582.05 | $582.05 | $582.05 | |
Cigna
| Professional | $582.05 | $582.05 | $582.05 | |
Providence
| Facility | $582.05 | $582.05 | $582.05 | |
Providence
| Professional | $582.05 | $735.70 | $818.22 | |
United
| Professional | $536.00 | $630.60 | $1,023.04 |