| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $329.70 | $329.70 | $329.70 | |
Cigna
| Facility | $435.89 | $435.89 | $435.89 | |
Cigna
| Professional | $435.89 | $435.89 | $435.89 | |
Providence
| Facility | $435.89 | $435.89 | $435.89 | |
Providence
| Professional | $435.89 | $520.65 | $612.54 | |
United
| Facility | $200.00 | $200.00 | $200.00 | |
United
| Professional | $615.16 | $686.15 | $780.77 |