| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $376.50 | $376.50 | $376.50 | |
Cigna
| Facility | $552.09 | $552.09 | $552.09 | |
Cigna
| Professional | $552.09 | $552.09 | $552.09 | |
Providence
| Facility | $552.09 | $552.09 | $552.09 | |
Providence
| Professional | $306.69 | $552.09 | $839.30 | |
United
| Professional | $611.50 | $719.39 | $971.26 |