| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $83.47 | $83.47 | $83.47 | |
Cigna
| Professional | $385.20 | $385.20 | $385.20 | |
Providence
| Facility | $77.05 | $77.05 | $77.05 | |
Providence
| Professional | $385.20 | $385.20 | $2,250,000.00 |