| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $155.00 | $155.00 | $155.00 | |
BCBS
| Professional | $0.72 | $0.96 | $1.28 | |
Cigna
| Professional | $23.95 | $23.95 | $29.94 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
Providence
| Facility | $17.53 | $17.53 | $17.53 |