| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $153.60 | $153.60 | $479.23 | |
Aetna
| Professional | $153.60 | $153.60 | $153.60 | |
Cigna
| Professional | $163.19 | $163.19 | $163.19 | |
Health Alliance Plan
| Facility | $153.60 | $192.00 | $427.39 | |
Health Alliance Plan
| Professional | $153.60 | $169.60 | $203.52 | |
United
| Professional | $160.00 | $160.00 | $169.74 |