| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $158.49 | $162.18 | $7,762.47 | |
Cigna
| Facility | $3,801.89 | $3,801.89 | $3,801.89 | |
Providence
| Facility | $134.90 | $380.19 | $1,230.27 | |
United
| Facility | $199.53 | $1,096.48 | $1,412.54 |