| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.68 | $74.44 | $95.53 | |
Cigna
| Professional | $95.53 | $95.53 | $95.53 | |
HMSA
| Professional | $70.86 | $83.36 | $99.51 | |
Kaiser Permanente
| Professional | $79.61 | $95.53 | $119.42 | |
United
| Professional | $33.44 | $95.53 | $180.84 | |
University Health Alliance
| Professional | $107.47 | $107.47 | $117.03 |