| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.78 | $42.78 | $133.47 | |
Aetna
| Professional | $42.78 | $42.78 | $42.78 | |
Cigna
| Professional | $34.81 | $45.46 | $45.46 | |
Health Alliance Plan
| Facility | $42.78 | $55.71 | $119.04 | |
Health Alliance Plan
| Professional | $42.78 | $47.24 | $56.68 |