| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $255.10 | $884.82 | $884.82 | |
Cigna
| Facility | $184.91 | $286.14 | $286.14 | |
Cigna
| Professional | $184.91 | $232.70 | $286.14 | |
Providence
| Facility | $135.90 | $272.52 | $286.14 | |
Providence
| Professional | $184.91 | $214.77 | $286.36 | |
United
| Professional | $109.91 | $121.61 | $192.87 |