| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $397.41 | $2,222.02 | $2,222.02 | |
Cigna
| Facility | $501.08 | $587.47 | $1,969.75 | |
Cigna
| Professional | $501.08 | $501.08 | $501.08 | |
Providence
| Facility | $501.08 | $587.47 | $1,969.75 | |
Providence
| Professional | $311.01 | $311.01 | $501.08 | |
United
| Professional | $145.13 | $145.13 | $345.57 |