| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.95 | $52.48 | $69.18 | |
Cigna
| Professional | $89.13 | $89.13 | $89.13 | |
Health Alliance Plan
| Facility | $70.79 | $70.79 | $186.21 | |
Health Alliance Plan
| Professional | $57.54 | $70.79 | $93.33 | |
Priority Health
| Professional | $89.13 | $89.13 | $89.13 |