| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $47.20 | $57.60 | $72.00 | |
Cigna
| Professional | $145.05 | $145.05 | $183.00 | |
Molina
| Professional | $60.00 | $60.00 | $85.00 | |
Providence
| Professional | $145.05 | $145.05 | $183.00 |