| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.26 | $1.26 | $1.26 | |
Cigna
| Professional | $191.26 | $191.26 | $191.26 | |
Providence
| Facility | $1.26 | $1.26 | $1.26 | |
Providence
| Professional | $191.26 | $191.26 | $2,400,000.00 |