| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.94 | $2,145.78 | $7,838.38 | |
Cigna
| Facility | $875.00 | $875.00 | $875.00 | |
Providence
| Facility | $104.80 | $132.41 | $875.00 | |
United
| Facility | $639.00 | $5,971.00 | $8,422.00 |