| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $58.55 | $64.34 | $17,005.14 | |
Health Alliance Plan
| Facility | $10,480.26 | $10,480.26 | $10,480.26 | |
Health Alliance Plan
| Professional | $10,480.26 | $10,480.26 | $13,624.33 |