| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $185.82 | $202.14 | $1,124.66 | |
Cigna
| Facility | $558.03 | $558.03 | $1,261.58 | |
Cigna
| Professional | $170.48 | $170.48 | $558.03 | |
Providence
| Facility | $558.03 | $558.03 | $1,261.58 | |
Providence
| Professional | $170.48 | $184.95 | $598.24 | |
United
| Professional | $170.48 | $170.48 | $170.48 |