| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $860.04 | $860.04 | $860.04 | |
Cigna
| Professional | $126.91 | $860.04 | $1,619.28 | |
Providence
| Facility | $107.74 | $491.54 | $1,300.63 | |
Providence
| Professional | $126.91 | $860.04 | $1,619.28 | |
United
| Professional | $603.98 | $755.72 | $1,259.53 |