| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.50 | $66.50 | $66.50 | |
Aetna
| Professional | $26.31 | $26.31 | $26.31 | |
Cigna
| Professional | $94.00 | $100.00 | $145.26 | |
Medcost
| Facility | $26.31 | $26.31 | $75.00 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |