| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.45 | $43.57 | $55.92 | |
Aetna
| Professional | $83.30 | $83.30 | $83.30 | |
Cigna
| Professional | $55.92 | $55.92 | $55.92 | |
HMSA
| Professional | $88.53 | $106.15 | $129.16 | |
Kaiser Permanente
| Professional | $51.26 | $55.92 | $65.23 | |
United
| Professional | $52.85 | $55.92 | $69.90 | |
University Health Alliance
| Professional | $39.61 | $68.50 | $125.88 |