| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.56 | $25.56 | $51.81 | |
Cigna
| Professional | $46.87 | $46.87 | $46.87 | |
Health Alliance Plan
| Professional | $25.56 | $27.06 | $148.00 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |