| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $146.66 | $146.66 | $146.66 | |
Cigna
| Professional | $10.52 | $10.52 | $128.85 | |
HMSA
| Professional | $19.32 | $19.32 | $19.32 | |
United
| Professional | $44.68 | $84.09 | $146.66 | |
University Health Alliance
| Professional | $259.87 | $259.87 | $259.87 |