| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,124.40 | $1,124.40 | $1,124.40 | |
Aetna
| Facility | 50 | $1,124.40 | $1,686.60 | $6,635.26 |
BCBS
| Facility | $47,000.00 | $81,499.99 | $94,999.99 | |
Cigna
| Facility | $782.39 | $782.39 | $782.39 | |
Providence
| Facility | $385.34 | $481.68 | $782.39 |