| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $60.53 | $68.59 | $88.04 | |
Aetna
| Professional | $39.97 | $39.97 | $39.97 | |
Cigna
| Professional | $41.23 | $88.04 | $88.04 | |
HMSA
| Professional | $84.00 | $99.12 | $115.50 | |
Kaiser Permanente
| Professional | $80.70 | $88.04 | $102.72 | |
United
| Professional | $75.44 | $88.04 | $110.06 | |
University Health Alliance
| Professional | $62.36 | $107.85 | $165.08 |