| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.47 | $19.47 | $19.47 | |
Aetna
| Professional | $7.87 | $17.60 | $19.47 | |
Cigna
| Professional | $10.93 | $12.04 | $12.04 | |
Molina
| Professional | $26.79 | $30.80 | $43.67 | |
Providence
| Facility | $16.30 | $21.11 | $23.15 | |
Providence
| Professional | $10.93 | $12.04 | $31.39 | |
United
| Professional | $10.51 | $11.36 | $17.13 |