| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $604.95 | $604.95 | $604.95 | |
BCBS
| Facility | $47,000.00 | $81,499.99 | $94,999.99 | |
Cigna
| Facility | $630.96 | $630.96 | $630.96 | |
Providence
| Facility | $312.30 | $390.38 | $630.96 |