| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.98 | $71.98 | $71.98 | |
Cigna
| Facility | $71.98 | $71.98 | $71.98 | |
Cigna
| Professional | $49.62 | $49.62 | $49.62 | |
HMSA
| Professional | $60.03 | $60.03 | $60.03 | |
United
| Professional | $45.54 | $48.65 | $72.98 | |
University Health Alliance
| Professional | $22.22 | $41.26 | $51.58 |