| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $382.81 | $382.81 | $382.81 | |
Cigna
| Professional | $40.29 | $382.81 | $540.96 | |
Providence
| Facility | $34.34 | $193.19 | $511.26 | |
Providence
| Professional | $40.29 | $382.81 | $540.96 | |
United
| Professional | $216.54 | $216.54 | $257.31 |