| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $281.92 | $2,064.30 | $2,064.30 | |
Cigna
| Facility | $347.13 | $563.42 | $563.42 | |
Cigna
| Professional | $347.13 | $458.20 | $563.42 | |
Providence
| Facility | $299.17 | $536.60 | $563.42 | |
Providence
| Professional | $347.13 | $422.88 | $563.84 | |
United
| Professional | $241.96 | $267.70 | $409.66 |