| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $125.89 | $125.89 | $125.89 | |
HMSA
| Professional | $131.83 | $131.83 | $131.83 | |
United
| Professional | $138.04 | $147.91 | $223.87 | |
University Health Alliance
| Professional | $74.13 | $74.13 | $87.10 |