| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $182.62 | $182.62 | $182.62 | |
Cigna
| Facility | $291.29 | $291.29 | $291.29 | |
Cigna
| Professional | $291.29 | $291.29 | $291.29 | |
Providence
| Facility | $54.86 | $138.54 | $291.29 | |
Providence
| Professional | $59.52 | $207.80 | $409.11 | |
United
| Professional | $262.60 | $320.06 | $511.53 |