| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $69.12 | $96.10 | $96.10 | |
Ambetter
| Professional | $57.89 | $58.30 | $95.58 | |
Cigna
| Professional | $20.93 | $20.93 | $20.93 | |
Medcost
| Facility | $96.10 | $98.02 | $163.37 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |