| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $480.55 | $1,001.14 | $1,922.19 | |
Aetna
| Professional | $480.55 | $800.91 | $800.91 | |
Cigna
| Professional | $328.00 | $736.38 | $920.47 | |
Providence
| Facility | $384.44 | $608.69 | $800.91 | |
Providence
| Professional | $328.00 | $525.40 | $640.73 | |
United
| Professional | $269.11 | $269.11 | $384.44 |