| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $124.50 | $124.50 | $124.50 | |
BCBS
| Facility | $47,000.00 | $81,499.99 | $94,999.99 | |
Cigna
| Professional | $127.50 | $127.50 | $127.50 | |
Providence
| Professional | $127.50 | $127.50 | $150.00 | |
United
| Professional | $125.00 | $125.00 | $125.00 |