| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $39.04 | $73.70 | $86.61 | |
Cigna
| Professional | $41.03 | $41.03 | $41.03 | |
Molina
| Professional | $60.00 | $124.04 | $144.41 | |
Providence
| Facility | $63.41 | $67.91 | $79.84 | |
Providence
| Professional | $41.03 | $41.03 | $82.50 | |
United
| Professional | $39.43 | $42.65 | $64.23 |