| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.59 | $70.59 | $70.59 | |
Cigna
| Facility | $70.59 | $70.59 | $70.59 | |
Cigna
| Professional | $46.87 | $46.87 | $46.87 | |
HMSA
| Professional | $55.46 | $55.46 | $55.46 | |
United
| Professional | $45.95 | $51.61 | $68.93 | |
University Health Alliance
| Professional | $11.94 | $35.15 | $47.65 |