| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $31.64 | $120.00 | $160.00 | |
Cigna
| Facility | $43.96 | $43.96 | $43.96 | |
Cigna
| Professional | $33.22 | $33.22 | $60.87 | |
HMSA
| Professional | $55.34 | $57.95 | $57.95 | |
Kaiser Permanente
| Professional | $33.20 | $55.34 | $77.48 | |
United
| Professional | $38.56 | $43.96 | $60.87 | |
University Health Alliance
| Professional | $25.88 | $44.57 | $52.67 |