| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.80 | $64.80 | $64.80 | |
Aetna
| Professional | $64.80 | $64.80 | $111.21 | |
BCBS
| Professional | $54.94 | $54.94 | $54.94 | |
Cigna
| Professional | $27.79 | $27.79 | $27.79 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 |