| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $29.00 | $29.00 | $29.00 | |
BCBS
| Professional | $1.09 | $1.46 | $1.94 | |
Cigna
| Professional | $25.19 | $25.19 | $31.49 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 | |
Providence
| Facility | $7.65 | $7.65 | $7.65 |