| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $169.88 | $169.88 | $1,854.44 | |
Providence
| Facility | $1,200.97 | $1,799.89 | $2,967.10 | |
Providence
| Professional | $169.88 | $169.88 | $1,854.44 | |
United
| Professional | $945.76 | $1,057.80 | $1,214.64 |