| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $678.78 | $678.78 | $678.78 | |
Cigna
| Facility | $536.83 | $536.83 | $536.83 | |
Cigna
| Professional | $536.83 | $536.83 | $536.83 | |
Providence
| Facility | $535.01 | $678.78 | $678.78 | |
Providence
| Professional | $536.83 | $536.83 | $536.83 |