| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $212.89 | $1,558.86 | $1,558.86 | |
Cigna
| Facility | $253.20 | $425.48 | $425.48 | |
Cigna
| Professional | $253.20 | $345.99 | $425.48 | |
Providence
| Facility | $225.91 | $405.22 | $425.48 | |
Providence
| Professional | $253.20 | $319.33 | $444.62 | |
United
| Professional | $182.71 | $202.16 | $231.41 |