| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21,903.30 | $41,903.60 | $85,136.80 | |
Cigna
| Facility | $64,051.69 | $64,051.69 | $68,053.73 | |
Premera BCBS
| Facility | $7,500.00 | $24,754.05 | $40,965.99 | |
Providence
| Facility | $7,500.00 | $25,966.95 | $68,053.73 |