| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31.76 | $46.20 | $204.35 | |
Aetna
| Professional | $33.47 | $33.57 | $37.82 | |
Cigna
| Professional | $30.62 | $46.20 | $46.20 | |
HMSA
| Professional | $62.58 | $82.54 | $96.64 | |
Kaiser Permanente
| Professional | $38.50 | $46.20 | $57.75 | |
United
| Professional | $16.17 | $46.20 | $74.73 | |
University Health Alliance
| Professional | $43.12 | $69.91 | $96.80 |