| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,046.60 | $2,046.60 | $2,046.60 | |
Cigna
| Facility | $242.39 | $242.39 | $242.39 | |
Providence
| Facility | $242.39 | $379.26 | $1,350.90 | |
United
| Facility | $200.00 | $200.00 | $200.00 |