| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.00 | $50.00 | $50.00 | |
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
Anthem BCBS
| Professional | $79.00 | $170.00 | $170.00 | |
Cigna
| Facility | $187.52 | $187.52 | $187.52 | |
Cigna
| Professional | $100.82 | $100.82 | $100.82 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |