| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $213.80 | $467.74 | $467.74 | |
Aetna
| Professional | $100.00 | $114.82 | $169.82 | |
Cigna
| Facility | $93.33 | $93.33 | $93.33 | |
Molina
| Professional | $218.78 | $218.78 | $309.03 | |
Providence
| Facility | $95.50 | $177.83 | $416.87 | |
Providence
| Professional | $151.36 | $158.49 | $204.17 | |
United
| Facility | $128.82 | $128.82 | $128.82 | |
United
| Professional | $60.26 | $60.26 | $85.11 |