| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $1,159.99 | $1,159.99 | $1,159.99 | |
Cigna
| Professional | $96.96 | $775.91 | $1,019.22 | |
HMSA
| Professional | $133.12 | $133.12 | $133.12 | |
United
| Professional | $550.09 | $1,035.41 | $1,159.99 | |
University Health Alliance
| Professional | $1,816.62 | $1,816.62 | $1,816.62 |