| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $483.15 | $483.15 | $483.15 | |
Cigna
| Facility | $843.91 | $843.91 | $843.91 | |
Cigna
| Professional | $629.52 | $843.91 | $843.91 | |
Providence
| Facility | $413.95 | $517.44 | $843.91 | |
Providence
| Professional | $452.90 | $679.42 | $1,004.82 | |
United
| Professional | $714.00 | $839.99 | $1,478.15 |