| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $7,100.47 | $7,100.47 | $7,100.47 | |
Cigna
| Professional | $7,100.47 | $7,100.47 | $7,313.48 | |
Providence
| Facility | $7,100.47 | $7,100.47 | $7,100.47 | |
Providence
| Professional | $7,100.47 | $7,100.47 | $7,313.48 |