| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.21 | $33.77 | $155.21 | |
Cigna
| Facility | $35.11 | $35.11 | $35.11 | |
Cigna
| Professional | $35.11 | $35.11 | $41.86 | |
Molina
| Professional | $4.26 | $7.99 | $75.00 | |
Providence
| Facility | $18.94 | $28.48 | $42.33 | |
Providence
| Professional | $35.11 | $35.11 | $41.86 | |
United
| Professional | $24.86 | $27.12 | $44.18 |