| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $32.00 | $32.00 | $32.00 | |
Aetna
| Professional | $32.00 | $32.00 | $32.00 | |
Cigna
| Facility | $5.85 | $5.85 | $64.00 | |
Cigna
| Professional | $17.20 | $17.20 | $17.20 | |
Medcost
| Facility | $32.00 | $36.79 | $67.70 | |
Molina
| Professional | $3,000.00 | $3,000.00 | $3,000.00 |