| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $142.50 | $195.83 | $580.33 | |
Cigna
| Professional | $215.17 | $215.17 | $215.17 | |
HMSA
| Professional | $207.35 | $207.35 | $207.35 | |
United
| Professional | $171.29 | $230.39 | $288.18 | |
University Health Alliance
| Professional | $58.38 | $142.79 | $192.15 |