| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.00 | $3.00 | $3.00 | |
Aetna
| Professional | $3.00 | $3.00 | $3.00 | |
Cigna
| Facility | $10.00 | $10.00 | $64.00 | |
Cigna
| Professional | $8.50 | $8.50 | $8.50 | |
Medcost
| Facility | $3.00 | $3.45 | $6.35 | |
Molina
| Professional | $3,000.00 | $3,000.00 | $3,000.00 |