| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $54.19 | $61.42 | $78.83 | |
Aetna
| Professional | $52.62 | $90.21 | $326.00 | |
Cigna
| Professional | $78.83 | $78.83 | $78.83 | |
HMSA
| Professional | $67.64 | $74.40 | $93.00 | |
Kaiser Permanente
| Professional | $72.26 | $78.83 | $91.97 | |
United
| Professional | $67.13 | $78.83 | $98.54 | |
University Health Alliance
| Professional | $45.98 | $82.11 | $147.80 |