| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $511.20 | $511.20 | $511.20 | |
Cigna
| Facility | $765.56 | $765.56 | $910.00 | |
Cigna
| Professional | $765.56 | $765.56 | $765.56 | |
Providence
| Facility | $765.56 | $765.56 | $910.00 | |
Providence
| Professional | $765.56 | $765.56 | $1,077.89 | |
United
| Professional | $444.71 | $525.46 | $1,347.73 |