| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $59.15 | $59.15 | $65.30 | |
Aetna
| Professional | $59.15 | $70.63 | $90.59 | |
BCBS
| Professional | $43.67 | $72.79 | $123.81 | |
Cigna
| Professional | $75.28 | $104.67 | $145.58 | |
Molina
| Professional | $32.34 | $32.34 | $128.40 | |
Providence
| Facility | $59.15 | $70.84 | $92.38 | |
Providence
| Professional | $66.16 | $102.36 | $145.58 | |
United
| Professional | $103.63 | $125.32 | $169.61 |