| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $173.59 | $173.59 | $175.30 | |
Aetna
| Professional | $171.78 | $173.59 | $175.30 | |
Cigna
| Professional | $141.60 | $141.60 | $141.60 | |
Health Alliance Plan
| Facility | $115.16 | $115.16 | $173.59 | |
Health Alliance Plan
| Professional | $115.16 | $131.81 | $193.80 | |
United
| Professional | $128.62 | $166.50 | $251.18 |