| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $205.83 | $939.38 | $939.38 | |
Cigna
| Facility | $281.83 | $281.83 | $281.83 | |
Cigna
| Professional | $253.50 | $281.83 | $281.83 | |
Providence
| Facility | $281.83 | $281.83 | $281.83 | |
Providence
| Professional | $175.01 | $253.50 | $378.70 | |
United
| Professional | $278.72 | $321.60 | $496.71 |