| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $77.05 | $124.09 | $437.44 | |
Aetna
| Professional | 52 | $38.53 | $218.72 | $352.41 |
BCBS
| Facility | $47,000.00 | $77,999.99 | $94,999.99 | |
BCBS
| Professional | $131.97 | $131.97 | $210.85 | |
Cigna
| Facility | $131.97 | $131.97 | $131.97 | |
Cigna
| Professional | $112.18 | $141.43 | $215.34 | |
Providence
| Facility | $73.43 | $128.99 | $215.80 | |
Providence
| Professional | $109.08 | $156.80 | $250.26 | |
United
| Professional | $192.56 | $215.80 | $235.77 |