| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $450.00 | $450.00 | $450.00 | |
Aetna
| Professional | $450.00 | $450.00 | $450.00 | |
Cigna
| Facility | $441.00 | $441.00 | $441.00 | |
Cigna
| Professional | $371.73 | $371.73 | $441.00 | |
Health Alliance Plan
| Facility | $450.00 | $450.00 | $450.00 | |
Health Alliance Plan
| Professional | $450.00 | $450.00 | $540.00 | |
United
| Professional | $442.62 | $511.71 | $721.86 |