| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $386.69 | $386.69 | $386.69 | |
Cigna
| Facility | $577.33 | $577.33 | $577.33 | |
Cigna
| Professional | $577.33 | $577.33 | $577.33 | |
Providence
| Facility | $577.33 | $577.33 | $577.33 | |
Providence
| Professional | $331.91 | $497.92 | $718.20 | |
United
| Professional | $434.78 | $560.38 | $986.52 |