| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $12.02 | $12.02 | $54.95 | |
Cigna
| Facility | $70.79 | $70.79 | $70.79 | |
DeanCare
| Facility | $12.02 | $12.02 | $12.02 | |
Medica
| Facility | $12.02 | $12.02 | $12.02 | |
Molina
| Professional | $32.36 | $33.11 | $85.11 |