| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.96 | $46.96 | $46.96 | |
Aetna
| Professional | $38.54 | $46.96 | $46.96 | |
Cigna
| Professional | $42.87 | $42.87 | $47.55 | |
Health Alliance Plan
| Facility | $46.96 | $46.96 | $46.96 | |
Health Alliance Plan
| Professional | $44.61 | $46.96 | $47.32 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |