| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.98 | $73.65 | $94.52 | |
Aetna
| Professional | $33.14 | $33.14 | $33.14 | |
Cigna
| Professional | $22.58 | $94.52 | $94.52 | |
HMSA
| Professional | $60.85 | $71.19 | $82.48 | |
Kaiser Permanente
| Professional | $78.77 | $94.52 | $118.16 | |
United
| Professional | $33.08 | $55.08 | $94.52 | |
University Health Alliance
| Professional | $43.62 | $65.42 | $115.79 |