| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.10 | $298.85 | $894.74 | |
Aetna
| Professional | $40.39 | $62.14 | $80.78 | |
Cigna
| Professional | $30.87 | $74.56 | $74.56 | |
HMSA
| Professional | $109.30 | $138.76 | $168.85 | |
Kaiser Permanente
| Professional | $62.14 | $74.56 | $93.21 | |
United
| Professional | $26.10 | $74.56 | $93.21 | |
University Health Alliance
| Professional | $69.59 | $103.75 | $147.65 |