| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $4,334.22 | $4,334.22 | $5,192.89 | |
Pacific Source
| Facility | $1,537.04 | $2,105.82 | $2,233.11 | |
Providence
| Facility | $2,629.02 | $2,830.01 | $2,830.01 | |
Providence
| Professional | $2,037.08 | $2,512.82 | $3,153.81 |