| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $838.49 | $838.49 | $838.49 | |
BCBS
| Facility | $47,000.00 | $81,499.99 | $94,999.99 | |
Cigna
| Facility | $247.13 | $247.13 | $247.13 | |
Providence
| Facility | $123.22 | $167.38 | $247.13 |