| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $750.00 | $1,715.53 | $5,619.00 | |
Cigna
| Facility | $400.00 | $1,325.00 | $4,635.00 | |
Providence
| Facility | $400.00 | $1,325.00 | $4,635.00 | |
United
| Facility | $430.00 | $482.00 | $1,205.00 |