| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.20 | $30.20 | $30.20 | |
Aetna
| Professional | $12.02 | $30.20 | $41.69 | |
BCBS
| Facility | $42.66 | $42.66 | $42.66 | |
Cigna
| Professional | $151.36 | $151.36 | $151.36 | |
Molina
| Professional | $32.36 | $45.71 | $60.26 | |
Providence
| Facility | $30.20 | $30.20 | $72.44 | |
Providence
| Professional | $60.26 | $60.26 | $89.13 |