| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $751.56 | $751.56 | $751.56 | |
Cigna
| Professional | $477.77 | $477.77 | $477.77 | |
Providence
| Facility | $717.57 | $717.57 | $717.57 | |
Providence
| Professional | $477.77 | $2,250,000.00 | $2,400,000.00 |