| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $47.89 | $57.29 | $190.00 | |
BCBS
| Professional | $37.71 | $48.97 | $49.48 | |
Molina
| Professional | $32.34 | $75.48 | $75.48 | |
Providence
| Facility | $19.32 | $19.32 | $19.32 | |
Providence
| Professional | $47.86 | $47.86 | $47.86 | |
United
| Professional | $46.01 | $73.44 | $91.40 |