| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $204.19 | $1,141.71 | $1,141.71 | |
Cigna
| Facility | $257.45 | $346.24 | $524.69 | |
Cigna
| Professional | $84.38 | $255.03 | $257.45 | |
Providence
| Facility | $257.45 | $346.24 | $524.69 | |
Providence
| Professional | $159.80 | $159.80 | $257.45 | |
United
| Professional | $74.58 | $74.58 | $177.56 |