| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $599.61 | $4,390.52 | $4,390.52 | |
Cigna
| Facility | $713.15 | $1,198.33 | $1,198.33 | |
Cigna
| Professional | $713.15 | $974.51 | $1,198.33 | |
Providence
| Facility | $636.29 | $1,141.28 | $1,198.33 | |
Providence
| Professional | $713.15 | $899.42 | $1,312.47 | |
United
| Professional | $514.61 | $569.38 | $871.30 |