| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $682.14 | $682.14 | $2,128.28 | |
Aetna
| Professional | $682.14 | $682.14 | $682.14 | |
Cigna
| Professional | $454.40 | $724.77 | $724.77 | |
Health Alliance Plan
| Facility | $682.14 | $852.67 | $1,898.05 | |
Health Alliance Plan
| Professional | $682.14 | $753.19 | $903.82 | |
United
| Professional | $710.56 | $710.56 | $753.83 |