| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.87 | $25.87 | $25.87 | |
Anthem BCBS
| Professional | $17.60 | $22.00 | $22.00 | |
CareSource
| Facility | $31.94 | $31.94 | $31.94 | |
Cigna
| Facility | $79.70 | $79.70 | $79.70 | |
Cigna
| Professional | $18.77 | $18.77 | $74.18 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |