| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $52.42 | $52.42 | $500.00 | |
Cigna
| Professional | $43.50 | $43.50 | $43.50 | |
Providence
| Facility | $52.42 | $52.42 | $52.42 | |
Providence
| Professional | $43.50 | $43.50 | $2,250,000.00 |