| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $60.59 | $60.59 | $60.59 | |
Aetna
| Professional | $37.47 | $60.59 | $69.97 | |
Cigna
| Facility | $71.95 | $71.95 | $71.95 | |
Cigna
| Professional | $300.91 | $300.91 | $300.91 | |
Health Alliance Plan
| Facility | $41.48 | $60.59 | $60.59 | |
Health Alliance Plan
| Professional | $48.00 | $60.59 | $70.31 | |
United
| Professional | $58.90 | $72.59 | $95.63 |