| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31.91 | $31.91 | $31.91 | |
Aetna
| Professional | $20.47 | $31.14 | $51.09 | |
Cigna
| Professional | $17.91 | $17.91 | $46.47 | |
Molina
| Professional | $52.68 | $71.56 | $71.56 | |
Providence
| Facility | $30.57 | $43.90 | $80.95 | |
Providence
| Professional | $17.91 | $17.91 | $61.88 | |
United
| Professional | $18.62 | $19.22 | $31.69 |