| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.81 | $28.81 | $28.81 | |
Aetna
| Professional | $28.81 | $31.70 | $35.92 | |
BCBS
| Professional | $21.00 | $21.00 | $21.00 | |
Cigna
| Professional | $21.90 | $21.90 | $21.90 | |
Molina
| Professional | $28.89 | $29.91 | $1,000.00 |