| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $428.20 | $428.20 | $428.20 | |
Cigna
| Professional | $77.83 | $428.20 | $1,010.28 | |
Providence
| Facility | $67.23 | $310.41 | $821.14 | |
Providence
| Professional | $77.83 | $428.20 | $1,010.28 | |
United
| Professional | $381.41 | $477.25 | $795.41 |