| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $967.96 | $967.96 | $967.96 | |
Pacific Source
| Facility | $1,071.43 | $1,071.43 | $79,999.20 | |
Pacific Source
| Professional | $1,071.43 | $1,071.43 | $1,071.43 | |
Providence
| Facility | $2,400,000.00 | $2,400,000.00 | $2,400,000.00 | |
Providence
| Professional | $967.96 | $2,250,000.00 | $2,400,000.00 |