| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.88 | $4.88 | $6.00 | |
Aetna
| Professional | $4.88 | $4.88 | $10.76 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $5.56 | $5.56 | $891.60 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 | |
Wellpoint
| Professional | $1.00 | $1.00 | $1.00 |