| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $912.27 | $912.27 | $912.27 | |
BCBS
| Facility | $47,000.00 | $81,499.99 | $94,999.99 | |
Cigna
| Professional | $1,101.47 | $1,101.47 | $1,101.47 | |
Providence
| Professional | $1,101.47 | $1,101.47 | $1,101.47 |