| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $193.04 | $273.36 | $438.72 | |
Molina
| Professional | $106.47 | $719.00 | $719.00 | |
Providence
| Facility | $229.97 | $229.97 | $229.97 | |
Providence
| Professional | $58.21 | $151.32 | $233.16 |