| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.62 | $11.62 | $36.25 | |
Aetna
| Professional | $11.62 | $11.62 | $11.62 | |
Cigna
| Professional | $14.52 | $14.52 | $15.57 | |
Health Alliance Plan
| Facility | $11.62 | $20.34 | $36.25 | |
Health Alliance Plan
| Professional | $11.62 | $14.24 | $17.07 | |
United
| Professional | $14.52 | $14.52 | $14.52 |