| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.22 | $63.22 | $63.22 | |
Cigna
| Facility | $63.22 | $63.22 | $63.22 | |
Cigna
| Professional | $36.77 | $36.77 | $36.77 | |
HMSA
| Professional | $50.62 | $50.62 | $50.62 | |
Kaiser Permanente
| Professional | $40.44 | $44.12 | $51.47 | |
United
| Professional | $36.77 | $41.60 | $55.16 | |
University Health Alliance
| Professional | $31.70 | $39.63 | $44.72 |