| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $115.61 | $115.61 | $1,475.04 | |
Providence
| Facility | $98.14 | $163.57 | $1,184.79 | |
Providence
| Professional | $115.61 | $115.61 | $1,475.04 | |
United
| Professional | $550.22 | $688.37 | $1,147.29 |