| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $676.08 | $676.08 | $1,698.24 | |
Cigna
| Facility | $537.03 | $537.03 | $537.03 | |
Cigna
| Professional | $537.03 | $537.03 | $549.54 | |
Providence
| Facility | $537.03 | $537.03 | $1,148.15 | |
Providence
| Professional | $79.43 | $79.43 | $537.03 |