| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.95 | $17.95 | $17.95 | |
Aetna
| Professional | $17.52 | $17.95 | $18.60 | |
Cigna
| Facility | $18.39 | $18.39 | $18.39 | |
Cigna
| Professional | $18.39 | $18.39 | $18.39 | |
Molina
| Professional | $22.24 | $24.31 | $45.00 |