| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $36.68 | $62.45 | $201.00 | |
BCBS
| Professional | $22.06 | $28.95 | $63.97 | |
Cigna
| Professional | $116.96 | $116.96 | $116.96 | |
Molina
| Professional | $77.09 | $77.09 | $77.09 | |
Providence
| Professional | $116.96 | $116.96 | $116.96 | |
United
| Professional | $54.95 | $79.50 | $103.35 |