| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $349.16 | $349.16 | $349.16 | |
Cigna
| Facility | $512.13 | $512.13 | $512.13 | |
Cigna
| Professional | $512.13 | $512.13 | $512.13 | |
Providence
| Facility | $512.13 | $512.13 | $512.13 | |
Providence
| Professional | $512.13 | $681.10 | $720.57 | |
United
| Professional | $496.74 | $584.40 | $900.94 |