| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $56.00 | $58.00 | $537.00 | |
Cigna
| Professional | $341.19 | $341.19 | $341.19 | |
Health Alliance Plan
| Facility | $618.25 | $618.25 | $618.25 | |
Health Alliance Plan
| Professional | $618.25 | $618.25 | $741.90 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |