| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $49.60 | $49.60 | $49.60 | |
Cigna
| Facility | $68.90 | $68.90 | $68.90 | |
Cigna
| Professional | $56.02 | $95.39 | $95.39 | |
HMSA
| Professional | $86.72 | $90.81 | $90.81 | |
Kaiser Permanente
| Professional | $52.03 | $86.72 | $121.41 | |
United
| Professional | $60.46 | $85.85 | $95.39 | |
University Health Alliance
| Professional | $57.97 | $72.25 | $82.54 |