| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $38.18 | $81.37 | $85.65 | |
Cigna
| Professional | $44.38 | $44.38 | $44.38 | |
Molina
| Professional | $60.00 | $136.93 | $159.43 | |
Providence
| Facility | $70.00 | $74.81 | $89.59 | |
Providence
| Professional | $44.38 | $44.38 | $87.41 | |
United
| Professional | $42.65 | $46.13 | $69.48 |