| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,880.90 | $2,880.90 | $2,880.90 | |
Aetna
| Professional | 50 | $98.88 | $148.32 | $897.15 |
BCBS
| Facility | $64,999.99 | $81,499.99 | $94,999.99 | |
Cigna
| Facility | $188.24 | $188.24 | $188.24 | |
Providence
| Facility | $126.96 | $188.24 | $334.86 |