| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $396.70 | $396.70 | $396.70 | |
Cigna
| Professional | $148.88 | $396.70 | $1,899.72 | |
Providence
| Facility | $126.40 | $396.70 | $1,525.95 | |
Providence
| Professional | $148.88 | $396.70 | $1,899.72 | |
United
| Professional | $709.07 | $886.51 | $886.51 |