| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $707.72 | $707.72 | $707.72 | |
Cigna
| Facility | $556.97 | $631.23 | $1,108.35 | |
Cigna
| Professional | $724.77 | $724.77 | $724.77 | |
Providence
| Facility | $556.97 | $631.23 | $1,108.35 | |
Providence
| Professional | $635.41 | $635.41 | $724.77 | |
United
| Professional | $710.56 | $710.56 | $710.56 |