| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7.08 | $7.08 | $7.08 | |
Aetna
| Professional | $7.08 | $7.08 | $7.08 | |
Anthem BCBS
| Professional | $4.37 | $4.37 | $4.57 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $4.37 | $4.37 | $4.37 | |
Molina
| Professional | $1,995.26 | $1,995.26 | $1,995.26 |