| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $854.38 | $1,023.64 | $1,166.11 | |
Health Alliance Plan
| Facility | $282.20 | $282.20 | $282.20 | |
Health Alliance Plan
| Professional | $282.20 | $282.20 | $440.85 | |
United
| Professional | $239.90 | $375.26 | $489.11 |