| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $538.20 | $3,009.24 | $3,009.24 | |
BCBS
| Professional | $627.12 | $627.12 | $627.12 | |
Cigna
| Facility | $678.60 | $795.60 | $2,667.60 | |
Cigna
| Professional | $220.98 | $678.60 | $678.60 | |
Providence
| Facility | $678.60 | $795.60 | $2,667.60 | |
Providence
| Professional | $421.20 | $421.20 | $678.60 | |
United
| Professional | $196.56 | $196.56 | $468.00 |