| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $71.66 | $210.02 | $777.99 | |
Cigna
| Facility | $1,206.19 | $1,206.19 | $1,206.19 | |
Cigna
| Professional | $258.22 | $630.72 | $1,206.19 | |
Providence
| Facility | $131.99 | $728.28 | $1,206.19 | |
Providence
| Professional | $233.91 | $630.72 | $1,800,000.00 | |
United
| Professional | $79.67 | $330.55 | $433.80 |