| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $439.00 | $439.00 | $439.00 | |
Cigna
| Facility | $389.09 | $389.09 | $854.57 | |
Cigna
| Professional | $389.09 | $426.92 | $426.92 | |
Providence
| Facility | $389.09 | $389.09 | $854.57 | |
Providence
| Professional | $259.37 | $389.09 | $465.31 | |
United
| Professional | $528.91 | $528.91 | $528.91 |