| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.74 | $48.98 | $58.88 | |
Aetna
| Professional | $36.31 | $45.71 | $77.62 | |
Cigna
| Professional | $35.48 | $35.48 | $58.88 | |
HMSA
| Professional | $67.61 | $87.10 | $97.72 | |
Kaiser Permanente
| Professional | $54.95 | $58.88 | $74.13 | |
United
| Professional | $33.88 | $58.88 | $95.50 | |
University Health Alliance
| Professional | $41.69 | $67.61 | $112.20 |