| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $416.87 | $2,754.23 | $8,128.31 | |
Aetna
| Professional | $398.11 | $398.11 | $3,019.95 | |
Cigna
| Professional | $1,047.13 | $1,047.13 | $1,047.13 | |
Health Alliance Plan
| Facility | $398.11 | $2,754.23 | $6,165.95 | |
Health Alliance Plan
| Professional | $398.11 | $398.11 | $2,630.27 | |
Priority Health
| Professional | $1,047.13 | $1,047.13 | $1,047.13 |