| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.00 | $7.50 | $20.00 | |
Cigna
| Professional | $101.39 | $211.89 | $255.12 | |
Health Alliance Plan
| Professional | $6.57 | $15.00 | $25.00 | |
Molina
| Professional | $30.00 | $30.00 | $100.00 |