| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.44 | $47.33 | $57.37 | |
Aetna
| Professional | $38.43 | $47.81 | $65.65 | |
Cigna
| Professional | $34.35 | $57.37 | $57.37 | |
HMSA
| Professional | $97.59 | $128.72 | $150.65 | |
Kaiser Permanente
| Professional | $47.81 | $57.37 | $71.72 | |
United
| Professional | $20.07 | $57.37 | $92.80 | |
University Health Alliance
| Professional | $47.81 | $77.00 | $117.22 |