| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $22.04 | $22.04 | $22.04 | |
Molina
| Professional | $28.47 | $28.47 | $29.94 | |
Providence
| Facility | $23.15 | $23.15 | $23.15 | |
Providence
| Professional | $19.38 | $19.38 | $22.04 | |
United
| Professional | $7.72 | $7.72 | $11.02 |