| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $134.90 | $162.18 | $162.18 | |
Cigna
| Professional | $181.97 | $181.97 | $181.97 | |
HMSA
| Professional | $173.78 | $173.78 | $173.78 | |
United
| Professional | $138.04 | $194.98 | $239.88 | |
University Health Alliance
| Professional | $40.74 | $131.83 | $173.78 |