| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.19 | $67.19 | $67.19 | |
Aetna
| Professional | $65.56 | $67.19 | $69.62 | |
Cigna
| Facility | $68.81 | $68.81 | $68.81 | |
Cigna
| Professional | $68.81 | $68.81 | $68.81 | |
Molina
| Professional | $42.38 | $42.38 | $46.33 |