| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $272.38 | $272.38 | $272.38 | |
Cigna
| Facility | $399.08 | $399.08 | $474.38 | |
Cigna
| Professional | $399.08 | $399.08 | $399.08 | |
Providence
| Facility | $399.08 | $399.08 | $474.38 | |
Providence
| Professional | $399.08 | $476.63 | $560.77 | |
United
| Professional | $387.10 | $455.40 | $701.14 |