| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.14 | $15.14 | $15.14 | |
Aetna
| Professional | $10.96 | $15.85 | $125.89 | |
BCBS
| Professional | $63.10 | $85.11 | $100.00 | |
Cigna
| Professional | $19.05 | $23.99 | $40.74 | |
Molina
| Professional | $50.12 | $60.26 | $112.20 | |
Providence
| Facility | $13.49 | $21.88 | $147.91 | |
Providence
| Professional | $19.05 | $23.99 | $30.20 | |
United
| Professional | $23.99 | $169.82 | $251.19 |