| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $155.50 | $617.01 | $884.79 | |
Cigna
| Facility | $265.52 | $265.52 | $265.52 | |
Cigna
| Professional | $227.39 | $265.52 | $1,075.58 | |
Providence
| Facility | $265.52 | $265.52 | $265.52 | |
Providence
| Professional | $173.85 | $545.74 | $1,075.58 | |
United
| Professional | $1,067.56 | $1,250.52 | $1,593.79 |