| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $57.82 | $82.05 | $363.71 | |
BCBS
| Professional | $42.62 | $58.35 | $78.77 | |
Cigna
| Professional | $150.85 | $150.85 | $150.85 | |
Molina
| Professional | $129.12 | $129.12 | $129.12 | |
Providence
| Professional | $150.85 | $150.85 | $150.85 | |
United
| Professional | $85.36 | $105.05 | $175.38 |