| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $3.90 | $3.90 | $3.90 | |
BCBS
| Facility | $47,000.00 | $81,499.99 | $94,999.99 | |
Providence
| Facility | $4.00 | $4.70 | $4.70 | |
Providence
| Professional | $1.60 | $1.60 | $1.60 | |
United
| Professional | $6.36 | $6.36 | $6.36 |