| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $199.15 | $1,113.48 | $1,113.48 | |
Cigna
| Facility | $251.10 | $294.39 | $987.07 | |
Cigna
| Professional | $119.08 | $251.10 | $251.10 | |
Providence
| Facility | $251.10 | $294.39 | $987.07 | |
Providence
| Professional | $155.85 | $155.85 | $251.10 | |
United
| Professional | $103.90 | $103.90 | $190.49 |