| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $469.00 | $469.00 | $469.00 | |
Cigna
| Professional | $120.90 | $469.00 | $1,460.76 | |
Providence
| Facility | $97.20 | $469.00 | $1,275.70 | |
Providence
| Professional | $120.90 | $469.00 | $1,460.76 | |
United
| Professional | $592.48 | $741.21 | $1,235.34 |