| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.50 | $38.50 | $38.50 | |
Aetna
| Professional | $24.29 | $38.50 | $42.50 | |
Cigna
| Facility | $48.09 | $48.09 | $48.09 | |
Cigna
| Professional | $201.14 | $201.14 | $201.14 | |
Health Alliance Plan
| Facility | $29.13 | $38.50 | $38.50 | |
Health Alliance Plan
| Professional | $31.29 | $38.50 | $45.39 | |
United
| Professional | $39.40 | $45.54 | $67.68 |