| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $279.67 | $970.00 | $970.00 | |
Cigna
| Facility | $244.07 | $369.65 | $369.65 | |
Cigna
| Professional | $244.07 | $300.61 | $369.65 | |
Providence
| Facility | $187.44 | $352.05 | $369.65 | |
Providence
| Professional | $244.07 | $277.44 | $386.86 | |
United
| Professional | $151.60 | $167.72 | $266.01 |