| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.95 | $19.95 | $19.95 | |
Aetna
| Professional | $19.95 | $19.95 | $19.95 | |
Anthem BCBS
| Professional | $30.20 | $30.20 | $30.20 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $28.18 | $28.18 | $28.18 | |
Molina
| Professional | $44.67 | $44.67 | $3,019.95 |