| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7.54 | $7.54 | $9.43 | |
Aetna
| Professional | $7.54 | $9.42 | $10.37 | |
Cigna
| Facility | $99.01 | $99.01 | $99.01 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
Providence
| Facility | $7.54 | $7.54 | $99.01 |