| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.94 | $19.94 | $19.94 | |
BCBS
| Facility | $47,000.00 | $81,499.99 | $94,999.99 | |
Cigna
| Professional | $20.43 | $20.43 | $20.43 | |
Providence
| Professional | $20.43 | $20.43 | $22.91 |