| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $977.24 | $1,548.82 | $8,709.64 | |
Cigna
| Facility | $2,691.53 | $2,691.53 | $2,691.53 | |
Providence
| Facility | $676.08 | $812.83 | $1,380.38 | |
United
| Facility | $794.33 | $7,762.47 | $16,982.44 |