| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $140.16 | $140.16 | $348.26 | |
Cigna
| Professional | $230.86 | $485.60 | $590.40 | |
Health Alliance Plan
| Facility | $95.35 | $95.35 | $131.91 | |
Health Alliance Plan
| Professional | $95.35 | $109.65 | $169.30 |