| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $226.22 | $549.04 | $885.61 | |
Aetna
| Professional | $226.22 | $226.22 | $309.50 | |
Cigna
| Professional | $348.00 | $348.00 | $348.00 | |
Health Alliance Plan
| Facility | $230.29 | $400.25 | $885.61 | |
Health Alliance Plan
| Professional | $226.22 | $226.22 | $297.68 | |
Molina
| Professional | $30.00 | $30.00 | $100.00 |