| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.32 | $69.50 | $89.20 | |
Aetna
| Professional | $60.00 | $102.07 | $168.74 | |
Cigna
| Professional | $89.20 | $89.20 | $89.20 | |
HMSA
| Professional | $94.24 | $113.00 | $137.50 | |
Kaiser Permanente
| Professional | $81.76 | $89.20 | $104.06 | |
United
| Professional | $89.20 | $99.25 | $141.22 | |
University Health Alliance
| Professional | $63.18 | $109.27 | $178.65 |