| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.45 | $48.11 | $61.74 | |
Aetna
| Professional | $10.17 | $35.75 | $39.31 | |
Cigna
| Professional | $61.74 | $61.74 | $61.74 | |
HMSA
| Professional | $93.90 | $103.29 | $129.11 | |
Kaiser Permanente
| Professional | $56.60 | $61.74 | $72.03 | |
United
| Professional | $51.45 | $61.74 | $77.18 | |
University Health Alliance
| Professional | $43.73 | $75.63 | $125.83 |