| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.34 | $113.72 | $145.96 | |
Aetna
| Professional | $136.16 | $136.16 | $167.03 | |
Cigna
| Professional | $90.89 | $145.96 | $145.96 | |
HMSA
| Professional | $115.54 | $138.54 | $153.25 | |
Kaiser Permanente
| Professional | $133.79 | $145.96 | $170.28 | |
United
| Professional | $145.96 | $165.68 | $236.09 | |
University Health Alliance
| Professional | $143.52 | $218.93 | $289.94 |