| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,460.00 | $5,460.00 | $5,460.00 | |
BCBS
| Facility | $47,000.00 | $77,999.99 | $94,999.99 | |
Cigna
| Facility | $115.68 | $115.68 | $115.68 | |
Providence
| Facility | $71.38 | $141.41 | $404.89 |