| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.31 | $28.54 | $144.01 | |
Cigna
| Facility | $31.91 | $31.91 | $31.91 | |
Cigna
| Professional | $31.91 | $31.91 | $39.89 | |
Molina
| Professional | $4.51 | $37.15 | $69.66 | |
Providence
| Facility | $31.91 | $32.86 | $35.78 | |
Providence
| Professional | $31.91 | $31.91 | $39.89 | |
United
| Professional | $22.52 | $24.57 | $40.95 |