| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $411.25 | $411.25 | $411.25 | |
Cigna
| Facility | $429.00 | $429.00 | $429.00 | |
Cigna
| Professional | $54.03 | $429.00 | $876.72 | |
Providence
| Facility | $50.82 | $285.89 | $652.03 | |
Providence
| Professional | $54.03 | $429.00 | $876.72 | |
United
| Professional | $255.58 | $272.19 | $453.65 |