| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $260.48 | $1,188.97 | $1,188.97 | |
Cigna
| Facility | $359.12 | $359.12 | $359.12 | |
Cigna
| Professional | $302.35 | $359.12 | $359.12 | |
Providence
| Facility | $359.12 | $359.12 | $359.12 | |
Providence
| Professional | $221.60 | $313.94 | $479.50 | |
United
| Professional | $350.89 | $407.40 | $628.99 |