| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $171.52 | $177.95 | $177.95 | |
Cigna
| Facility | $182.24 | $182.24 | $182.24 | |
Cigna
| Professional | $182.24 | $182.24 | $182.24 | |
Providence
| Facility | $171.52 | $171.52 | $182.24 | |
Providence
| Professional | $182.24 | $182.24 | $2,400,000.00 |