| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $634.32 | $685.00 | $5,492.03 | |
Cigna
| Facility | $887.00 | $887.00 | $887.00 | |
Providence
| Facility | $887.00 | $887.00 | $887.00 | |
United
| Facility | $1,241.00 | $1,241.00 | $1,241.00 |