| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $200.00 | $210.00 | $276.88 | |
Aetna
| Professional | $35.00 | $52.00 | $248.00 | |
Cigna
| Professional | $142.50 | $734.22 | $1,260.00 | |
Health Alliance Plan
| Facility | $208.00 | $208.00 | $276.88 | |
Health Alliance Plan
| Professional | $52.00 | $210.00 | $288.00 | |
Molina
| Professional | $28.25 | $65.30 | $75.00 | |
United
| Professional | $42.00 | $54.00 | $86.00 |