| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $274.39 | $274.39 | $274.39 | |
Aetna
| Professional | $23.94 | $23.94 | $108.80 | |
Cigna
| Professional | $17.28 | $17.28 | $17.28 | |
HMSA
| Professional | $28.27 | $37.29 | $43.66 | |
United
| Professional | $16.78 | $16.78 | $77.42 | |
University Health Alliance
| Professional | $4.63 | $7.82 | $10.39 |