| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $32.46 | $32.46 | $134.71 | |
Cigna
| Professional | $14.22 | $14.22 | $14.22 | |
Molina
| Professional | $27.05 | $32.46 | $44.09 | |
Providence
| Facility | $20.38 | $28.09 | $35.53 | |
Providence
| Professional | $14.22 | $32.46 | $37.60 | |
United
| Professional | $11.36 | $11.70 | $16.23 |