| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,652.17 | $1,652.17 | $6,088.24 | |
Cigna
| Professional | $504.00 | $504.00 | $3,283.89 | |
Providence
| Facility | $1,404.34 | $1,652.17 | $6,697.06 | |
Providence
| Professional | $504.00 | $504.00 | $3,283.89 |