| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $91.67 | $183.33 | $366.66 | |
Aetna
| Professional | $91.67 | $146.66 | $785.88 | |
Cigna
| Facility | $79.44 | $79.44 | $79.44 | |
Cigna
| Professional | $109.46 | $182.00 | $250.30 | |
Molina
| Professional | $60.00 | $60.00 | $199.22 | |
Providence
| Facility | $79.44 | $150.88 | $190.12 | |
Providence
| Professional | $140.55 | $155.22 | $215.71 | |
United
| Professional | $51.33 | $63.37 | $73.33 |