| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $252.63 | $252.63 | $252.63 | |
BCBS
| Facility | $47,000.00 | $77,999.99 | $94,999.99 | |
Cigna
| Facility | $499.51 | $499.51 | $499.51 | |
Providence
| Facility | $307.12 | $487.93 | $652.74 |