| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $161.74 | $161.74 | $161.74 | |
Aetna
| Professional | $79.70 | $79.70 | $79.70 | |
Cigna
| Professional | $78.93 | $78.93 | $78.93 | |
HMSA
| Professional | $117.47 | $117.47 | $117.47 | |
Kaiser Permanente
| Professional | $86.83 | $94.72 | $110.51 | |
United
| Professional | $78.93 | $96.55 | $118.40 | |
University Health Alliance
| Professional | $82.07 | $97.74 | $105.87 |