| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.74 | $40.74 | $40.74 | |
Cigna
| Facility | $40.74 | $40.74 | $40.74 | |
Cigna
| Professional | $53.87 | $53.87 | $53.87 | |
HMSA
| Professional | $32.88 | $32.88 | $32.88 | |
United
| Professional | $49.45 | $52.82 | $79.23 | |
University Health Alliance
| Professional | $22.60 | $29.15 | $61.43 |