| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $183.42 | $288.05 | $470.62 | |
Cigna
| Facility | $481.63 | $481.63 | $481.63 | |
Cigna
| Professional | $481.63 | $481.63 | $481.63 | |
Providence
| Facility | $124.04 | $271.48 | $502.99 | |
Providence
| Professional | $147.16 | $377.24 | $552.35 | |
United
| Professional | $443.19 | $512.71 | $651.61 |