| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $98.90 | $98.90 | $98.90 | |
Aetna
| Professional | $42.39 | $98.90 | $117.40 | |
Cigna
| Professional | $137.59 | $137.59 | $137.59 | |
Health Alliance Plan
| Facility | $98.90 | $101.55 | $101.55 | |
Health Alliance Plan
| Professional | $37.11 | $98.90 | $110.84 | |
United
| Professional | $95.20 | $117.86 | $164.39 |