| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12,956.98 | $12,956.98 | $12,956.98 | |
BCBS
| Facility | $47,000.00 | $81,499.99 | $94,999.99 | |
Cigna
| Facility | $381.73 | $381.73 | $381.73 | |
Providence
| Facility | $381.73 | $458.25 | $485.76 |