| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $44.41 | $93.53 | $106.38 | |
Cigna
| Professional | $51.62 | $51.62 | $51.62 | |
Molina
| Professional | $95.00 | $198.05 | $198.05 | |
Providence
| Facility | $86.96 | $91.31 | $106.38 | |
Providence
| Professional | $51.62 | $51.62 | $96.43 | |
United
| Professional | $49.61 | $53.66 | $80.83 |