| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $30.90 | $64.57 | $83.18 | |
Cigna
| Professional | $37.15 | $37.15 | $37.15 | |
Molina
| Professional | $95.50 | $95.50 | $134.90 | |
Providence
| Facility | $56.23 | $77.62 | $100.00 | |
Providence
| Professional | $38.02 | $38.02 | $38.02 | |
United
| Professional | $35.48 | $38.02 | $57.54 |