| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $343.49 | $343.49 | $343.49 | |
Cigna
| Facility | $502.66 | $502.66 | $502.66 | |
Cigna
| Professional | $502.66 | $502.66 | $502.66 | |
Providence
| Facility | $502.66 | $502.66 | $502.66 | |
Providence
| Professional | $502.66 | $601.13 | $707.25 | |
United
| Professional | $487.55 | $564.04 | $884.29 |