| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.00 | $120.00 | $120.00 | |
Cigna
| Facility | $8.94 | $37.45 | $1,568.82 | |
Health Alliance Plan
| Facility | $120.00 | $120.00 | $120.00 | |
Molina
| Facility | $1,220.00 | $1,220.00 | $1,220.00 |