| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.00 | $4.00 | $4.00 | |
Aetna
| Professional | $4.00 | $4.00 | $4.00 | |
BCBS
| Professional | $3.29 | $3.29 | $3.29 | |
Cigna
| Professional | $1.76 | $1.76 | $1.76 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |