| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,850.09 | $1,850.09 | $1,850.09 | |
Cigna
| Professional | $249.23 | $1,850.09 | $3,591.81 | |
Providence
| Facility | $1,850.09 | $2,907.65 | $5,746.90 | |
Providence
| Professional | $249.23 | $1,850.09 | $3,591.81 | |
United
| Professional | $1,555.14 | $1,555.14 | $2,232.23 |