| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $244.67 | $323.83 | $455.32 | |
Cigna
| Facility | $687.75 | $687.75 | $687.75 | |
Cigna
| Professional | $359.63 | $359.63 | $687.75 | |
Providence
| Facility | $272.26 | $579.38 | $803.28 | |
Providence
| Professional | $359.63 | $687.75 | $2,400,000.00 | |
United
| Professional | $258.19 | $283.23 | $283.23 |