| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.75 | $71.75 | $156.41 | |
Aetna
| Professional | $25.87 | $25.87 | $345.00 | |
Cigna
| Professional | $18.77 | $18.77 | $120.00 | |
Medcost
| Facility | $8.00 | $25.87 | $31.04 | |
Medcost
| Professional | $8.00 | $8.00 | $8.00 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |