| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $149.74 | $189.61 | $477.48 | |
Health Alliance Plan
| Facility | $83.73 | $83.73 | $83.73 | |
Health Alliance Plan
| Professional | $83.73 | $87.46 | $118.50 | |
United
| Professional | $39.08 | $56.63 | $101.59 |