| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $32.47 | $32.47 | $32.47 | |
Cigna
| Facility | $57.04 | $57.04 | $57.04 | |
Cigna
| Professional | $46.99 | $46.99 | $78.98 | |
HMSA
| Professional | $71.80 | $75.18 | $75.18 | |
Kaiser Permanente
| Professional | $50.26 | $71.80 | $100.52 | |
United
| Professional | $40.44 | $57.04 | $78.98 | |
University Health Alliance
| Professional | $57.84 | $59.82 | $68.34 |