| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.99 | $41.99 | $41.99 | |
Aetna
| Professional | $37.86 | $43.91 | $48.80 | |
Cigna
| Professional | $44.04 | $44.04 | $44.44 | |
Molina
| Professional | $32.34 | $32.34 | $76.31 | |
Providence
| Facility | $39.79 | $43.56 | $59.87 | |
Providence
| Professional | $44.04 | $44.04 | $47.35 | |
United
| Professional | $65.53 | $82.69 | $108.38 |