| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4.00 | $4.00 | $4.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $3.24 | $3.24 | $3.24 | |
Medcost
| Facility | $1.95 | $4.00 | $6.80 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |