| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $641.00 | $641.00 | $641.00 | |
Cigna
| Facility | $300.00 | $1,325.00 | $4,635.00 | |
Providence
| Facility | $300.00 | $1,325.00 | $4,635.00 | |
United
| Facility | $653.00 | $1,205.00 | $2,780.00 |