| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $44.80 | $50.77 | $65.16 | |
Aetna
| Professional | $56.08 | $56.08 | $56.08 | |
Cigna
| Professional | $65.16 | $65.16 | $65.16 | |
HMSA
| Professional | $48.33 | $56.86 | $67.88 | |
Kaiser Permanente
| Professional | $54.30 | $65.16 | $81.45 | |
United
| Professional | $22.81 | $65.16 | $81.45 | |
University Health Alliance
| Professional | $38.01 | $67.88 | $97.74 |