| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.12 | $0.12 | $0.15 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $2.12 | $4.88 | $4.88 | |
Medcost
| Facility | $0.12 | $0.13 | $0.60 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |