| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $228.87 | $239.19 | $5,205.42 | |
Aetna
| Professional | $239.19 | $239.19 | $917.92 | |
Health Alliance Plan
| Facility | $232.65 | $239.19 | $14,000.00 | |
Health Alliance Plan
| Professional | $239.19 | $239.19 | $305.52 | |
Molina
| Professional | $30.00 | $30.00 | $100.00 |