| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.43 | $10.43 | $10.43 | |
Cigna
| Facility | $85.00 | $85.00 | $85.00 | |
Cigna
| Professional | $7.87 | $7.87 | $14.08 | |
HMSA
| Professional | $12.48 | $12.48 | $13.07 | |
United
| Professional | $7.93 | $12.37 | $18.86 |