| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $1,869.00 | $1,869.00 | $2,239.27 | |
Pacific Source
| Facility | $636.42 | $882.29 | $955.42 | |
Providence
| Facility | $1,116.17 | $1,202.20 | $8,663.00 | |
Providence
| Professional | $864.86 | $1,055.85 | $1,325.21 |