| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $707.95 | $707.95 | $1,348.96 | |
Cigna
| Professional | $1,288.25 | $1,288.25 | $1,548.82 | |
Providence
| Facility | $707.95 | $741.31 | $1,584.89 | |
Providence
| Professional | $79.43 | $79.43 | $85.11 |