| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,659.59 | $1,659.59 | $6,025.60 | |
Cigna
| Professional | $501.19 | $501.19 | $3,311.31 | |
Providence
| Facility | $1,659.59 | $1,659.59 | $6,760.83 | |
Providence
| Professional | $79.43 | $79.43 | $501.19 |