| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $323.59 | $323.59 | $323.59 | |
Health Alliance Plan
| Facility | $288.40 | $288.40 | $288.40 | |
Priority Health
| Professional | $323.59 | $323.59 | $323.59 | |
United
| Facility | $100.00 | $138.04 | $436.52 |