| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $45.71 | $45.71 | $51.29 | |
Health Alliance Plan
| Facility | $186.21 | $457.09 | $512.86 | |
Health Alliance Plan
| Professional | $173.78 | $194.98 | $245.47 | |
Priority Health
| Professional | $45.71 | $45.71 | $45.71 | |
United
| Facility | $9.55 | $23.99 | $169.82 | |
United
| Professional | $23.99 | $28.84 | $43.65 |