| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.04 | $4.04 | $4.04 | |
Aetna
| Professional | $4.04 | $4.04 | $4.04 | |
Cigna
| Facility | $3.96 | $3.96 | $64.00 | |
Cigna
| Professional | $2.98 | $2.98 | $2.98 | |
Medcost
| Facility | $4.04 | $4.66 | $8.55 | |
Molina
| Professional | $3,000.00 | $3,000.00 | $3,000.00 |