| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.12 | $50.12 | $50.12 | |
Aetna
| Professional | $34.67 | $47.86 | $1,230.27 | |
Cigna
| Professional | $457.09 | $562.34 | $724.44 | |
Molina
| Professional | $165.96 | $562.34 | $724.44 | |
Providence
| Facility | $30.20 | $177.83 | $4,073.80 | |
Providence
| Professional | $489.78 | $676.08 | $831.76 | |
United
| Professional | $42.66 | $57.54 | $87.10 |