| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $249.71 | $866.08 | $866.08 | |
Cigna
| Facility | $194.51 | $236.40 | $236.40 | |
Cigna
| Professional | $194.51 | $207.36 | $236.40 | |
Providence
| Facility | $125.52 | $225.14 | $236.40 | |
Providence
| Professional | $177.43 | $194.51 | $236.57 | |
United
| Professional | $101.51 | $112.32 | $178.13 |