| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.36 | $190.36 | $661.77 | |
Aetna
| Facility | 25 | $369.36 | $369.36 | $369.36 |
BCBS
| Facility | $64,999.99 | $81,499.99 | $94,999.99 | |
Cigna
| Facility | $152.47 | $152.47 | $181.25 | |
Providence
| Facility | $81.36 | $148.19 | $197.71 |