| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $465.20 | $2,601.06 | $2,601.06 | |
Cigna
| Facility | $586.54 | $687.68 | $2,305.76 | |
Cigna
| Professional | $586.54 | $586.54 | $586.54 | |
Providence
| Facility | $586.54 | $687.68 | $2,305.76 | |
Providence
| Professional | $364.07 | $364.07 | $586.54 | |
United
| Professional | $137.71 | $169.90 | $404.52 |