| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $740.46 | $954.93 | $3,408.56 | |
Cigna
| Facility | $1,081.57 | $1,081.57 | $1,081.57 | |
Cigna
| Professional | $532.77 | $883.62 | $1,081.57 | |
Providence
| Facility | $534.02 | $581.40 | $1,081.57 | |
Providence
| Professional | $662.20 | $993.41 | $1,432.90 | |
United
| Professional | $960.85 | $1,092.73 | $1,213.44 |