| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $75.70 | $75.70 | $994.68 | |
Providence
| Facility | $66.18 | $110.30 | $799.15 | |
Providence
| Professional | $75.70 | $75.70 | $994.68 | |
United
| Professional | $371.02 | $464.26 | $773.76 |