| 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 | $1,231.95 | $1,231.95 | $1,231.95 | |
Providence
| Facility | $612.79 | $842.60 | $1,231.95 |