| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.32 | $112.32 | $112.32 | |
Aetna
| Professional | $78.12 | $112.32 | $112.32 | |
BCBS
| Professional | $26.00 | $26.00 | $26.00 | |
Cigna
| Professional | $2.00 | $2.00 | $2.00 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 |