| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $32.36 | $32.36 | $32.36 | |
Aetna
| Professional | $32.36 | $32.36 | $32.36 | |
Anthem BCBS
| Professional | $5.62 | $6.61 | $7.08 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $17.38 | $17.38 | $17.38 | |
Molina
| Professional | $30.20 | $30.20 | $1,995.26 |