| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $278.19 | $1,555.42 | $1,555.42 | |
Cigna
| Facility | $350.76 | $411.23 | $1,378.83 | |
Cigna
| Professional | $141.19 | $350.76 | $350.76 | |
Providence
| Facility | $350.76 | $411.23 | $1,378.83 | |
Providence
| Professional | $217.71 | $217.71 | $350.76 | |
United
| Professional | $101.60 | $101.60 | $241.90 |