| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $272.14 | $1,168.31 | $1,168.31 | |
Cigna
| Facility | $455.34 | $455.34 | $455.34 | |
Providence
| Facility | $455.34 | $455.34 | $455.34 | |
Providence
| Professional | $210.28 | $297.89 | $629.57 | |
United
| Professional | $305.52 | $377.03 | $416.03 |