| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.30 | $46.30 | $46.30 | |
Aetna
| Professional | $29.33 | $46.30 | $81.48 | |
Cigna
| Professional | $64.00 | $64.00 | $76.68 | |
Molina
| Professional | $31.33 | $60.00 | $85.00 | |
Providence
| Facility | $25.54 | $48.59 | $57.74 | |
United
| Professional | $51.60 | $61.20 | $82.79 |