| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.78 | $46.78 | $46.78 | |
Aetna
| Professional | $36.90 | $52.92 | $87.64 | |
Cigna
| Professional | $56.17 | $84.73 | $110.31 | |
Molina
| Professional | $32.34 | $32.34 | $85.75 | |
Providence
| Professional | $64.95 | $84.73 | $110.31 | |
United
| Facility | $775.00 | $1,327.00 | $1,327.00 | |
United
| Professional | $73.92 | $92.40 | $130.35 |