| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $945.00 | $3,682.00 | $12,040.00 | |
Aetna
| Professional | $0.02 | $2,901.00 | $12,281.00 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Providence
| Professional | $2,250,000.00 | $2,400,000.00 | $2,400,000.00 |