| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $450.00 | $450.00 | $450.00 | |
Cigna
| Professional | $97.68 | $450.00 | $1,224.00 | |
Providence
| Facility | $81.44 | $389.52 | $1,030.83 | |
Providence
| Professional | $97.68 | $450.00 | $1,224.00 | |
United
| Professional | $478.54 | $598.94 | $998.24 |