| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $100.00 | $100.00 | $100.00 | |
Cigna
| Professional | $111.37 | $111.37 | $111.37 | |
Providence
| Facility | $100.00 | $100.00 | $100.00 | |
Providence
| Professional | $111.37 | $111.37 | $2,400,000.00 |