| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.98 | $48.98 | $48.98 | |
Aetna
| Professional | $48.98 | $48.98 | $48.98 | |
Anthem BCBS
| Professional | $70.79 | $870.96 | $870.96 | |
Cigna
| Facility | $9.77 | $54.95 | $1,288.25 | |
Cigna
| Professional | $1,096.48 | $1,288.25 | $1,288.25 | |
Molina
| Professional | $100.00 | $100.00 | $100.00 |