| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $297.00 | $297.00 | $297.00 | |
BCBS
| Professional | $0.69 | $0.93 | $1.24 | |
Cigna
| Professional | $28.50 | $28.50 | $35.61 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
Providence
| Facility | $19.05 | $19.05 | $19.05 |