| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $422.00 | $422.00 | $422.00 | |
Anthem BCBS
| Professional | $0.02 | $624.54 | $624.54 | |
Cigna
| Facility | $34.92 | $64.00 | $64.00 | |
Cigna
| Professional | $5.25 | $5.25 | $104.57 | |
Molina
| Professional | $100.00 | $100.00 | $100.00 |