| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $16.39 | $16.39 | $17.35 | |
Cigna
| Professional | $21.44 | $21.44 | $21.44 | |
Health Alliance Plan
| Professional | $16.39 | $16.39 | $88.00 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |