| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.40 | $212.80 | $884.64 | |
Aetna
| Professional | $106.31 | $116.95 | $779.54 | |
Cigna
| Professional | $109.99 | $109.99 | $109.99 | |
HMSA
| Professional | $138.40 | $138.40 | $144.91 | |
United
| Professional | $421.74 | $421.74 | $675.87 | |
University Health Alliance
| Professional | $122.00 | $122.00 | $122.00 |