| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $206.12 | $412.25 | $824.49 | |
Aetna
| Professional | $206.12 | $329.80 | $329.80 | |
Cigna
| Facility | $178.64 | $178.64 | $178.64 | |
Molina
| Professional | $425.99 | $447.97 | $447.97 | |
Providence
| Facility | $178.64 | $178.64 | $346.29 | |
Providence
| Professional | $289.95 | $289.95 | $329.80 | |
United
| Professional | $115.43 | $115.43 | $164.90 |