| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.10 | $96.10 | $96.10 | |
Aetna
| Professional | $69.12 | $96.10 | $166.22 | |
Ambetter
| Professional | $49.98 | $58.80 | $58.80 | |
BCBS
| Professional | $26.00 | $26.00 | $26.00 | |
Cigna
| Professional | $20.93 | $20.93 | $20.93 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |