| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $504.77 | $2,822.32 | $2,822.32 | |
Cigna
| Facility | $636.45 | $855.91 | $1,297.04 | |
Cigna
| Professional | $636.45 | $636.45 | $1,872.96 | |
Providence
| Facility | $636.45 | $855.91 | $1,297.04 | |
Providence
| Professional | $395.04 | $438.93 | $636.45 | |
United
| Professional | $184.35 | $252.88 | $602.10 |