| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $758.56 | $758.56 | $758.56 | |
Cigna
| Professional | $776.84 | $776.84 | $776.84 | |
Providence
| Professional | $776.84 | $776.84 | $776.84 | |
United
| Professional | $761.61 | $761.61 | $761.61 |