| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.30 | $0.50 | $0.50 | |
Aetna
| Professional | $0.50 | $0.50 | $2,659.86 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $1.21 | $1.21 | $1.21 | |
Molina
| Professional | $0.75 | $0.75 | $40.00 | |
Wellpoint
| Professional | $0.18 | $0.18 | $0.18 |