| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $412.05 | $412.05 | $412.05 | |
Cigna
| Facility | $770.82 | $770.82 | $770.82 | |
Cigna
| Professional | $655.20 | $770.82 | $770.82 | |
Providence
| Facility | $247.90 | $351.53 | $469.79 | |
Providence
| Professional | $655.20 | $770.82 | $848.55 | |
United
| Professional | $596.96 | $677.32 | $746.20 |