| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $359.59 | $359.59 | $359.59 | |
Cigna
| Professional | $359.59 | $880.56 | $1,288.74 | |
Providence
| Facility | $346.63 | $359.59 | $1,077.26 | |
Providence
| Professional | $359.59 | $370.38 | $1,288.74 | |
United
| Professional | $498.35 | $530.74 | $884.56 |