| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.26 | $1.26 | $1.26 | |
Aetna
| Professional | $1.26 | $1.26 | $1.26 | |
Anthem BCBS
| Professional | $125.00 | $168.00 | $168.00 | |
Cigna
| Facility | $171.21 | $171.21 | $171.21 | |
Cigna
| Professional | $196.48 | $196.48 | $202.23 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |