| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $70.54 | $70.54 | $70.54 | |
Cigna
| Facility | $174.76 | $174.76 | $174.76 | |
Cigna
| Professional | $147.05 | $242.00 | $242.00 | |
HMSA
| Professional | $220.00 | $230.37 | $230.37 | |
Kaiser Permanente
| Professional | $132.00 | $220.00 | $308.00 | |
United
| Professional | $143.24 | $174.76 | $242.00 | |
University Health Alliance
| Professional | $96.22 | $177.21 | $209.40 |