| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $269.15 | $269.15 | $269.15 | |
Aetna
| Professional | $147.91 | $218.78 | $281.84 | |
Cigna
| Professional | $239.88 | $239.88 | $239.88 | |
HMSA
| Professional | $251.19 | $251.19 | $251.19 | |
United
| Professional | $199.53 | $281.84 | $323.59 | |
University Health Alliance
| Professional | $154.88 | $181.97 | $223.87 |