| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $151.53 | $5,000.27 | $7,838.38 | |
Cigna
| Facility | $1,300.00 | $1,300.00 | $1,300.00 | |
Providence
| Facility | $86.78 | $140.53 | $192.00 | |
United
| Facility | $350.00 | $2,358.00 | $2,877.00 |