| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $347.16 | $347.16 | $607.54 | |
Cigna
| Professional | $347.16 | $434.84 | $607.54 | |
Providence
| Facility | $173.04 | $578.62 | $695.74 | |
Providence
| Professional | $347.16 | $434.84 | $607.54 | |
United
| Professional | $221.77 | $252.90 | $421.50 |