| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $36.26 | $76.65 | $133.46 | |
Aetna
| Professional | 25 | $70.76 | $78.51 | $193.44 |
BCBS
| Facility | $68,099.99 | $68,099.99 | $81,499.99 | |
BCBS
| Professional | $109.94 | $117.78 | $129.35 | |
Cigna
| Facility | $100.11 | $117.78 | $129.35 | |
Cigna
| Professional | $73.55 | $117.78 | $182.88 | |
Providence
| Facility | $60.06 | $77.34 | $117.78 | |
Providence
| Professional | $84.08 | $140.10 | $205.19 | |
United
| Professional | $115.69 | $139.79 | $162.77 |