| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.83 | $20.83 | $20.83 | |
Aetna
| Professional | $20.83 | $20.83 | $29.28 | |
Anthem BCBS
| Professional | $12.32 | $14.50 | $15.99 | |
Cigna
| Facility | $45.00 | $75.00 | $126.53 | |
Cigna
| Professional | $93.67 | $93.67 | $93.67 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |