| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,298.70 | $1,298.70 | $1,298.70 | |
Aetna
| Facility | 50 | $5,584.36 | $9,552.48 | $21,140.84 |
BCBS
| Facility | $47,000.00 | $81,499.99 | $94,999.99 | |
Cigna
| Facility | $592.58 | $592.58 | $592.58 | |
Providence
| Facility | $291.86 | $900.90 | $954.44 |