| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $181.39 | $181.39 | $181.39 | |
BCBS
| Facility | $47,000.00 | $81,499.99 | $94,999.99 | |
Cigna
| Facility | $918.57 | $918.57 | $918.57 | |
Providence
| Facility | $454.34 | $624.72 | $918.57 |