| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.20 | $134.90 | $165.96 | |
Aetna
| Professional | $74.13 | $117.49 | $173.78 | |
Cigna
| Professional | $70.79 | $74.13 | $165.96 | |
HMSA
| Professional | $144.54 | $194.98 | $194.98 | |
Kaiser Permanente
| Professional | $151.36 | $165.96 | $204.17 | |
United
| Professional | $69.18 | $138.04 | $204.17 | |
University Health Alliance
| Professional | $117.49 | $199.53 | $309.03 |