| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.45 | $22.16 | $29.55 | |
Cigna
| Professional | $12.15 | $12.15 | $12.15 | |
Molina
| Professional | $47.24 | $55.00 | $95.00 | |
Providence
| Facility | $20.48 | $25.34 | $28.68 | |
Providence
| Professional | $12.15 | $12.15 | $22.16 | |
United
| Professional | $11.68 | $12.62 | $19.02 |