| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,185.42 | $2,185.42 | $2,185.42 | |
Cigna
| Facility | $3,268.37 | $3,268.37 | $3,268.37 | |
Cigna
| Professional | $3,268.37 | $3,268.37 | $3,268.37 | |
Providence
| Facility | $3,268.37 | $3,268.37 | $3,268.37 | |
Providence
| Professional | $1,419.62 | $2,546.77 | $3,889.90 | |
United
| Professional | $2,130.13 | $2,686.42 | $4,721.79 |