| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.00 | $14.66 | $16.04 | |
BCBS
| Facility | $19.95 | $19.95 | $21.95 | |
BCBS
| Professional | $19.00 | $19.00 | $19.00 | |
Cigna
| Professional | $0.12 | $0.12 | $0.12 | |
Molina
| Professional | $20.00 | $20.00 | $25.00 |