| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.20 | $30.20 | $30.20 | |
Aetna
| Professional | $14.13 | $30.20 | $33.11 | |
Cigna
| Professional | $40.74 | $40.74 | $40.74 | |
Molina
| Professional | $32.36 | $60.26 | $1,000.00 | |
Providence
| Facility | $16.22 | $32.36 | $67.61 | |
United
| Professional | $2.63 | $17.78 | $35.48 |