| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $65.00 | $65.00 | $65.00 | |
BCBS
| Professional | $1.57 | $1.82 | $2.42 | |
Cigna
| Professional | $21.06 | $21.06 | $26.33 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
Providence
| Facility | $13.56 | $13.56 | $13.56 |