| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $999.36 | $999.36 | $999.36 | |
Cigna
| Professional | $99.55 | $999.36 | $1,137.96 | |
Providence
| Facility | $75.72 | $397.08 | $1,050.38 | |
Providence
| Professional | $99.55 | $999.36 | $1,137.96 | |
United
| Professional | $487.83 | $610.41 | $1,017.37 |