| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.90 | $40.90 | $40.90 | |
Aetna
| Professional | $39.89 | $47.62 | $63.67 | |
Cigna
| Professional | $43.15 | $43.15 | $43.48 | |
Molina
| Professional | $32.34 | $32.34 | $74.81 | |
Providence
| Facility | $39.32 | $45.90 | $65.58 | |
Providence
| Professional | $43.15 | $43.15 | $51.54 | |
United
| Professional | $58.90 | $80.59 | $111.19 |