| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $22.91 | $22.91 | $22.91 | |
Anthem BCBS
| Professional | $18.62 | $21.88 | $21.88 | |
Cigna
| Facility | $75.86 | $75.86 | $75.86 | |
Cigna
| Professional | $75.86 | $75.86 | $75.86 | |
Molina
| Professional | $44.67 | $44.67 | $44.67 |