| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $1,355.47 | $1,355.47 | $1,694.34 | |
Health Alliance Plan
| Facility | $1,067.65 | $1,067.65 | $1,067.65 | |
Health Alliance Plan
| Professional | $1,067.65 | $1,067.65 | $1,334.56 |