| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $332.39 | $398.21 | $398.21 | |
Cigna
| Facility | $363.97 | $363.97 | $363.97 | |
Cigna
| Professional | $329.05 | $329.05 | $363.97 | |
Providence
| Facility | $363.97 | $363.97 | $363.97 | |
Providence
| Professional | $329.05 | $356.99 | $465.65 | |
United
| Professional | $329.05 | $329.05 | $329.05 |