| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $283.14 | $283.14 | $283.14 | |
Cigna
| Facility | $441.15 | $441.15 | $441.15 | |
Cigna
| Professional | $441.15 | $441.15 | $441.15 | |
Providence
| Facility | $441.15 | $441.15 | $441.15 | |
Providence
| Professional | $441.15 | $496.75 | $584.44 | |
United
| Professional | $402.91 | $474.00 | $730.75 |