| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $563.98 | $1,956.11 | $1,956.11 | |
Cigna
| Facility | $427.13 | $634.17 | $634.17 | |
Cigna
| Professional | $427.13 | $515.72 | $634.17 | |
Providence
| Facility | $336.73 | $603.98 | $634.17 | |
Providence
| Professional | $427.13 | $475.98 | $634.64 | |
United
| Professional | $272.33 | $301.32 | $464.32 |