| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $148.47 | $148.47 | $148.47 | |
Aetna
| Professional | $48.00 | $98.15 | $119.00 | |
Cigna
| Professional | $96.58 | $96.58 | $96.58 | |
HMSA
| Professional | $93.00 | $93.00 | $93.00 | |
Kaiser Permanente
| Professional | $107.98 | $117.79 | $137.41 | |
United
| Professional | $100.19 | $103.33 | $129.35 | |
University Health Alliance
| Professional | $53.13 | $70.97 | $98.16 |