| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.89 | $0.89 | $0.89 | |
BCBS
| Facility | $47,000.00 | $81,499.99 | $94,999.99 | |
Cigna
| Facility | $1,238.78 | $1,238.78 | $1,238.78 | |
Providence
| Facility | $613.03 | $842.92 | $1,238.78 |