| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $43.00 | $43.00 | $43.00 | |
BCBS
| Professional | $2.04 | $2.73 | $3.64 | |
Cigna
| Professional | $21.89 | $21.89 | $27.36 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
Providence
| Facility | $14.92 | $14.92 | $14.92 |