| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $219.78 | $219.78 | $219.78 | |
Cigna
| Professional | $35.88 | $219.78 | $388.02 | |
Providence
| Facility | $44.49 | $251.29 | $620.83 | |
Providence
| Professional | $35.88 | $219.78 | $388.02 | |
United
| Professional | $197.89 | $220.00 | $220.00 |