| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $501.47 | $600.78 | $600.78 | |
Cigna
| Facility | $566.97 | $566.97 | $566.97 | |
Cigna
| Professional | $496.74 | $496.74 | $566.97 | |
Providence
| Facility | $566.97 | $566.97 | $566.97 | |
Providence
| Professional | $496.74 | $538.91 | $702.93 | |
United
| Professional | $496.74 | $496.74 | $496.74 |