| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.33 | $47.97 | $61.57 | |
Aetna
| Professional | $38.28 | $38.28 | $51.31 | |
Cigna
| Professional | $40.64 | $61.57 | $61.57 | |
HMSA
| Professional | $80.15 | $100.36 | $116.95 | |
Kaiser Permanente
| Professional | $56.44 | $61.57 | $71.83 | |
United
| Professional | $61.57 | $72.22 | $99.61 | |
University Health Alliance
| Professional | $43.61 | $69.27 | $115.45 |