| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $11,619.91 | $11,619.91 | $11,619.91 | |
Cigna
| Professional | $11,619.91 | $11,619.91 | $11,619.91 | |
Providence
| Facility | $11,619.91 | $11,619.91 | $11,619.91 | |
Providence
| Professional | $11,619.91 | $11,619.91 | $11,619.91 |