| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $250.24 | $1,832.33 | $1,832.33 | |
Cigna
| Facility | $297.62 | $567.64 | $567.64 | |
Cigna
| Professional | $297.62 | $461.61 | $567.64 | |
Providence
| Facility | $265.55 | $540.61 | $567.64 | |
Providence
| Professional | $297.62 | $426.04 | $571.84 | |
United
| Professional | $214.76 | $237.62 | $272.01 |