| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $445.63 | $445.63 | $445.63 | |
Cigna
| Facility | $668.82 | $668.82 | $668.82 | |
Cigna
| Professional | $668.82 | $668.82 | $668.82 | |
Providence
| Facility | $668.82 | $668.82 | $668.82 | |
Providence
| Professional | $386.26 | $579.45 | $883.32 | |
United
| Professional | $532.66 | $647.11 | $1,119.85 |