| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $35.54 | $35.54 | $35.54 | |
Cigna
| Facility | $130.12 | $130.12 | $130.12 | |
Cigna
| Professional | $73.27 | $73.27 | $180.17 | |
HMSA
| Professional | $163.79 | $171.51 | $171.51 | |
Kaiser Permanente
| Professional | $98.27 | $163.79 | $229.31 | |
United
| Professional | $74.19 | $130.12 | $180.17 | |
University Health Alliance
| Professional | $71.64 | $131.94 | $155.90 |