| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.00 | $20.01 | $50.00 | |
Cigna
| Professional | $0.51 | $0.51 | $0.51 | |
Health Alliance Plan
| Professional | $6.84 | $6.84 | $8.55 | |
Molina
| Professional | $30.00 | $30.00 | $50.00 |