| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.80 | $8.00 | $8.00 | |
Aetna
| Professional | $8.00 | $8.00 | $8.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $40.20 | $310.19 | $310.19 | |
Molina
| Professional | $5.30 | $5.30 | $40.00 |