| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $200.00 | $200.00 | $200.00 | |
Cigna
| Professional | $98.81 | $200.00 | $1,103.28 | |
Providence
| Facility | $73.42 | $200.00 | $1,042.56 | |
Providence
| Professional | $98.81 | $200.00 | $1,103.28 | |
United
| Professional | $484.07 | $605.87 | $1,009.79 |