| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $112.59 | $112.59 | $112.59 | |
Cigna
| Facility | $178.55 | $178.55 | $178.55 | |
Cigna
| Professional | $159.06 | $204.75 | $284.52 | |
HMSA
| Professional | $67.75 | $190.99 | $219.32 | |
United
| Professional | $73.31 | $264.20 | $265.37 | |
University Health Alliance
| Professional | $123.80 | $237.15 | $284.73 |