| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $327.62 | $327.62 | $327.62 | |
Cigna
| Professional | $38.27 | $327.62 | $542.40 | |
Providence
| Facility | $62.20 | $327.62 | $867.84 | |
Providence
| Professional | $38.27 | $327.62 | $542.40 | |
United
| Professional | $213.29 | $227.15 | $378.58 |