| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $56.55 | $64.09 | $82.26 | |
Aetna
| Professional | $31.56 | $31.56 | $31.56 | |
Cigna
| Professional | $82.26 | $82.26 | $82.26 | |
HMSA
| Professional | $67.12 | $74.58 | $82.50 | |
Kaiser Permanente
| Professional | $75.41 | $82.26 | $95.97 | |
United
| Professional | $59.55 | $82.26 | $102.83 | |
University Health Alliance
| Professional | $58.27 | $85.69 | $145.68 |