| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $42.66 | $87.10 | $102.33 | |
Cigna
| Professional | $50.12 | $50.12 | $50.12 | |
Molina
| Professional | $95.50 | $95.50 | $158.49 | |
Providence
| Facility | $72.44 | $97.72 | $125.89 | |
Providence
| Professional | $51.29 | $51.29 | $51.29 | |
United
| Professional | $43.65 | $52.48 | $77.62 |