| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.53 | $30.53 | $30.53 | |
Aetna
| Professional | $30.54 | $30.54 | $42.00 | |
Cigna
| Professional | $150.94 | $150.94 | $150.94 | |
Medcost
| Facility | $30.54 | $31.46 | $47.81 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |