| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $56.23 | $67.61 | $83.18 | |
Aetna
| Professional | $32.36 | $57.54 | $85.11 | |
Cigna
| Professional | $30.90 | $30.90 | $83.18 | |
HMSA
| Professional | $69.18 | $85.11 | $93.33 | |
Kaiser Permanente
| Professional | $75.86 | $83.18 | $102.33 | |
United
| Professional | $29.51 | $58.88 | $102.33 | |
University Health Alliance
| Professional | $58.88 | $89.13 | $144.54 |