| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,987.50 | $1,987.50 | $6,407.46 | |
Cigna
| Professional | $504.00 | $3,119.76 | $9,173.91 | |
Providence
| Facility | $1,689.38 | $1,987.50 | $7,048.21 | |
Providence
| Professional | $504.00 | $504.00 | $3,119.76 |