| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $13.45 | $13.45 | $13.45 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $13.25 | $13.25 | $13.25 | |
HMSA
| Professional | $15.61 | $15.61 | $15.61 | |
United
| Professional | $8.36 | $13.04 | $19.88 |