| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $853.45 | $853.45 | $853.45 | |
Cigna
| Facility | $881.10 | $881.10 | $881.10 | |
Cigna
| Professional | $109.87 | $881.10 | $1,970.40 | |
Providence
| Facility | $111.66 | $628.07 | $1,432.11 | |
Providence
| Professional | $109.87 | $881.10 | $1,970.40 | |
United
| Professional | $665.04 | $826.52 | $826.52 |