| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.69 | $1.69 | $1.69 | |
Aetna
| Professional | $1.69 | $1.69 | $2.15 | |
Cigna
| Facility | $2.22 | $2.22 | $64.00 | |
Cigna
| Professional | $1.89 | $1.89 | $1.89 | |
Medcost
| Facility | $1.69 | $2.02 | $3.58 | |
Molina
| Professional | $3,000.00 | $3,000.00 | $3,000.00 |