| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $30.00 | $30.00 | $30.00 | |
Cigna
| Facility | $45.00 | $45.00 | $60.00 | |
Cigna
| Professional | $45.00 | $45.00 | $62.50 | |
Molina
| Professional | $32.34 | $60.00 | $60.00 | |
Providence
| Facility | $30.00 | $30.00 | $60.00 | |
Providence
| Professional | $30.00 | $45.00 | $62.50 |