| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $75.52 | $75.52 | $852.36 | |
Providence
| Facility | $56.71 | $94.52 | $796.70 | |
Providence
| Professional | $75.52 | $75.52 | $852.36 | |
United
| Professional | $370.13 | $462.96 | $771.60 |