| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.00 | $20.00 | $20.00 | |
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
BCBS
| Professional | $1.74 | $1.74 | $1.74 | |
Cigna
| Professional | $18.70 | $18.70 | $18.70 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |