| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $166.63 | $166.63 | $259.94 | |
Aetna
| Professional | $150.84 | $166.63 | $166.63 | |
BCBS
| Facility | $143.13 | $200.14 | $348.46 | |
Cigna
| Professional | $80.23 | $104.85 | $312.50 | |
Health Alliance Plan
| Facility | $166.63 | $166.63 | $306.18 | |
Health Alliance Plan
| Professional | $166.63 | $168.38 | $210.48 | |
Molina
| Professional | $145.22 | $159.75 | $261.41 | |
United
| Professional | $73.67 | $105.24 | $175.40 |