| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $406.89 | $406.89 | $406.89 | |
Cigna
| Facility | $316.74 | $316.74 | $316.74 | |
Cigna
| Professional | $52.19 | $316.74 | $858.12 | |
Providence
| Facility | $48.62 | $273.51 | $623.67 | |
Providence
| Professional | $52.19 | $316.74 | $858.12 | |
United
| Professional | $249.07 | $265.26 | $442.10 |