| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $126.80 | $126.80 | $126.80 | |
Aetna
| Professional | $65.80 | $77.06 | $118.00 | |
Cigna
| Professional | $80.88 | $80.88 | $80.88 | |
HMSA
| Professional | $77.86 | $77.86 | $77.86 | |
Kaiser Permanente
| Professional | $77.41 | $84.45 | $98.53 | |
United
| Professional | $84.45 | $86.54 | $108.35 | |
University Health Alliance
| Professional | $52.62 | $68.15 | $75.84 |