| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $254.94 | $254.94 | $254.94 | |
Aetna
| Professional | $17.60 | $254.94 | $622.74 | |
Anthem BCBS
| Professional | $21.25 | $25.00 | $28.80 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $11.30 | $11.30 | $11.30 | |
Molina
| Professional | $45.00 | $45.00 | $3,000.00 |