| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.88 | $33.88 | $33.88 | |
Aetna
| Professional | $30.90 | $33.88 | $34.67 | |
Cigna
| Professional | $2.04 | $2.04 | $2.04 | |
Health Alliance Plan
| Facility | $33.88 | $33.88 | $33.88 | |
Health Alliance Plan
| Professional | $30.90 | $33.88 | $33.88 | |
Priority Health
| Professional | $2.04 | $2.04 | $2.04 |