| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $93.06 | $93.06 | $93.06 | |
Aetna
| Professional | $55.47 | $55.47 | $61.02 | |
Cigna
| Professional | $55.47 | $55.47 | $64.97 | |
HMSA
| Professional | $67.40 | $67.40 | $67.40 | |
Kaiser Permanente
| Professional | $55.47 | $66.56 | $83.21 | |
United
| Professional | $55.22 | $58.47 | $83.21 | |
University Health Alliance
| Professional | $48.08 | $61.66 | $69.84 |