| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.39 | $66.56 | $386.10 | |
Aetna
| Professional | $14.39 | $14.39 | $14.39 | |
Cigna
| Professional | $2.02 | $2.02 | $2.02 | |
Health Alliance Plan
| Facility | $2.11 | $66.56 | $386.10 | |
Health Alliance Plan
| Professional | $2.11 | $2.31 | $14.39 | |
Molina
| Professional | $30.00 | $30.00 | $100.00 |