| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24,878.00 | $47,594.60 | $96,699.40 | |
Cigna
| Facility | $72,750.71 | $72,750.71 | $77,296.28 | |
Premera BCBS
| Facility | $7,500.00 | $28,115.96 | $40,931.64 | |
Providence
| Facility | $7,500.00 | $25,945.18 | $77,296.28 |