| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $69.12 | $96.10 | $98.73 | |
Cigna
| Professional | $20.93 | $20.93 | $20.93 | |
Molina
| Professional | $60.00 | $60.00 | $1,500.00 | |
Providence
| Facility | $69.13 | $96.10 | $98.73 | |
Providence
| Professional | $20.93 | $20.93 | $2,250,000.00 |