| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.69 | $17.69 | $17.69 | |
Aetna
| Professional | $15.45 | $15.83 | $17.69 | |
Molina
| Professional | $14.93 | $14.93 | $22.39 | |
Providence
| Facility | $7.06 | $15.83 | $18.62 | |
United
| Professional | $17.30 | $17.30 | $17.30 |