| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $39.70 | $39.70 | $39.70 | |
Cigna
| Professional | $131.35 | $131.35 | $131.35 | |
HMSA
| Professional | $115.20 | $115.20 | $115.20 | |
United
| Professional | $99.84 | $140.74 | $175.92 | |
University Health Alliance
| Professional | $39.93 | $46.88 | $55.15 |