| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $411.25 | $411.25 | $411.25 | |
Aetna
| Professional | $232.50 | $330.75 | $938.40 | |
Cigna
| Professional | $368.58 | $368.58 | $368.58 | |
HMSA
| Professional | $355.28 | $355.28 | $355.28 | |
United
| Professional | $287.92 | $394.76 | $493.64 | |
University Health Alliance
| Professional | $239.88 | $282.20 | $322.99 |