| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $43.65 | $100.00 | $112.20 | |
Cigna
| Professional | $51.29 | $51.29 | $51.29 | |
Molina
| Professional | $95.50 | $95.50 | $181.97 | |
Providence
| Facility | $75.86 | $109.65 | $131.83 | |
Providence
| Professional | $52.48 | $52.48 | $52.48 | |
United
| Professional | $44.67 | $53.70 | $81.28 |