| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $25.44 | $38.54 | $42.38 | |
Health Alliance Plan
| Facility | $72.31 | $72.31 | $72.31 | |
Health Alliance Plan
| Professional | $43.37 | $72.31 | $72.31 | |
Molina
| Professional | $149.81 | $224.71 | $224.71 |