| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $226.01 | $452.03 | $904.05 | |
Aetna
| Professional | $226.01 | $361.62 | $361.62 | |
Cigna
| Facility | $195.88 | $195.88 | $195.88 | |
Molina
| Professional | $467.09 | $491.20 | $491.20 | |
Providence
| Facility | $195.88 | $195.88 | $379.70 | |
Providence
| Professional | $317.92 | $317.92 | $361.62 | |
United
| Professional | $126.57 | $126.57 | $180.81 |