| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $124.95 | $124.95 | $1,594.08 | |
Providence
| Facility | $106.07 | $176.79 | $1,280.58 | |
Providence
| Professional | $124.95 | $124.95 | $1,594.08 | |
United
| Professional | $594.46 | $744.02 | $1,240.04 |