| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.20 | $30.20 | $30.20 | |
Aetna
| Professional | $30.20 | $30.20 | $41.69 | |
BCBS
| Professional | $34.67 | $34.67 | $34.67 | |
Cigna
| Professional | $151.36 | $151.36 | $151.36 | |
Molina
| Professional | $21.38 | $38.02 | $67.61 |