| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.74 | $29.74 | $29.74 | |
Aetna
| Professional | $29.74 | $29.74 | $37.17 | |
BCBS
| Professional | $14.03 | $14.03 | $14.03 | |
Cigna
| Professional | $872.98 | $872.98 | $872.98 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |