| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.00 | $1.00 | $1.00 | |
Aetna
| Professional | $1.00 | $1.00 | $1.00 | |
Ambetter
| Professional | $12.88 | $12.88 | $12.88 | |
Cigna
| Professional | $0.20 | $0.20 | $0.20 | |
Medcost
| Facility | $1.74 | $1.86 | $2.95 | |
Molina
| Professional | $30.20 | $30.20 | $54.95 |