| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $14.47 | $20.39 | $72.00 | |
BCBS
| Professional | $12.93 | $17.16 | $36.07 | |
Cigna
| Professional | $40.81 | $40.81 | $40.81 | |
Molina
| Professional | $38.13 | $38.13 | $38.13 | |
Providence
| Professional | $40.81 | $40.81 | $40.81 | |
United
| Professional | $21.50 | $26.40 | $34.56 |