| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.02 | $0.02 | $0.02 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 | |
Lucent Health
| Professional | $901.50 | $901.50 | $901.50 | |
Providence
| Professional | $1,800,000.00 | $1,800,000.00 | $1,800,000.00 | |
Wellpoint
| Professional | $1.26 | $1.26 | $1.70 |