| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.84 | $28.84 | $28.84 | |
Aetna
| Professional | $28.84 | $28.84 | $37.15 | |
BCBS
| Professional | $14.13 | $14.13 | $14.13 | |
Cigna
| Professional | $870.96 | $870.96 | $870.96 | |
Molina
| Professional | $21.38 | $25.12 | $50.12 |