| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $579.07 | $600.79 | $600.79 | |
Cigna
| Facility | $615.26 | $615.26 | $615.26 | |
Cigna
| Professional | $615.26 | $615.26 | $615.26 | |
Providence
| Facility | $579.07 | $723.84 | $904.80 | |
Providence
| Professional | $615.26 | $868.61 | $904.80 | |
United
| Professional | $723.84 | $723.84 | $723.84 |