| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,862.09 | $1,862.09 | $5,495.41 | |
Cigna
| Professional | $501.19 | $501.19 | $2,238.72 | |
Providence
| Facility | $1,862.09 | $1,995.26 | $6,165.95 | |
Providence
| Professional | $79.43 | $79.43 | $501.19 |