| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $361.61 | $1,446.42 | $1,446.42 | |
Aetna
| Professional | $361.61 | $361.61 | $950.00 | |
Cigna
| Facility | $313.39 | $313.39 | $313.39 | |
Molina
| Professional | $747.32 | $785.89 | $785.89 | |
Providence
| Facility | $207.31 | $261.20 | $313.39 | |
Providence
| Professional | $218.71 | $583.39 | $670.17 | |
United
| Professional | $87.07 | $87.07 | $124.39 |