| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.00 | $4.00 | $4.00 | |
Aetna
| Professional | $4.00 | $4.00 | $4.00 | |
Anthem BCBS
| Professional | $1.11 | $1.30 | $1.30 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $4.93 | $4.93 | $4.93 | |
Molina
| Professional | $45.00 | $45.00 | $3,000.00 |