| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $181.97 | $389.05 | $407.38 | |
Aetna
| Professional | $85.11 | $114.82 | $812.83 | |
Cigna
| Facility | $79.43 | $79.43 | $79.43 | |
Cigna
| Professional | $109.65 | $154.88 | $213.80 | |
Molina
| Professional | $60.26 | $60.26 | $263.03 | |
Providence
| Facility | $81.28 | $190.55 | $363.08 | |
Providence
| Professional | $107.15 | $162.18 | $213.80 | |
United
| Facility | $109.65 | $109.65 | $109.65 | |
United
| Professional | $51.29 | $63.10 | $74.13 |