| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $84.19 | $84.95 | $84.95 | |
BCBS
| Professional | $57.75 | $75.45 | $142.63 | |
Cigna
| Professional | $84.00 | $202.00 | $202.00 | |
Molina
| Professional | $70.00 | $122.37 | $1,500.00 | |
Providence
| Facility | $72.20 | $84.95 | $103.55 | |
Providence
| Professional | $84.00 | $202.00 | $202.00 | |
United
| Facility | $233.00 | $233.00 | $233.00 |