| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.33 | $87.33 | $87.33 | |
Aetna
| Professional | $24.52 | $35.64 | $71.40 | |
Cigna
| Professional | $34.49 | $42.39 | $117.04 | |
Kaiser Permanente
| Professional | $34.44 | $37.57 | $47.47 | |
United
| Professional | $33.06 | $42.39 | $63.38 | |
University Health Alliance
| Professional | $24.54 | $29.80 | $40.67 |