| 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 | |
Cigna
| Facility | $64.00 | $64.00 | $1,195.85 | |
Cigna
| Professional | $872.98 | $872.98 | $872.98 | |
Medcost
| Facility | $29.74 | $35.69 | $62.93 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |