| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $237.07 | $425.00 | $638.00 | |
Cigna
| Professional | $1,717.98 | $1,717.98 | $1,717.98 | |
Providence
| Facility | $250.00 | $425.00 | $454.75 | |
Providence
| Professional | $1,717.98 | $2,250,000.00 | $2,400,000.00 |