| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $29.84 | $61.61 | $65.54 | |
Cigna
| Professional | $32.19 | $32.19 | $32.19 | |
Molina
| Professional | $85.49 | $85.49 | $121.99 | |
Providence
| Facility | $53.57 | $56.59 | $65.73 | |
Providence
| Professional | $32.19 | $32.19 | $67.25 | |
United
| Professional | $30.94 | $33.46 | $50.40 |