| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $327.54 | $327.54 | $327.54 | |
Aetna
| Professional | $318.00 | $327.54 | $327.54 | |
Cigna
| Professional | $309.32 | $318.00 | $353.90 | |
Health Alliance Plan
| Facility | $225.00 | $318.00 | $327.54 | |
Health Alliance Plan
| Professional | $318.00 | $318.00 | $429.30 | |
Molina
| Professional | $30.00 | $349.80 | $477.00 | |
United
| Professional | $318.00 | $318.00 | $342.74 |