| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $516.79 | $516.79 | $883.70 | |
Cigna
| Professional | $516.79 | $883.70 | $883.70 | |
Providence
| Facility | $516.79 | $673.06 | $1,173.70 | |
Providence
| Professional | $516.79 | $733.56 | $883.70 | |
United
| Professional | $374.12 | $419.88 | $699.80 |