| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $33.70 | $33.70 | $33.70 | |
Cigna
| Facility | $48.70 | $48.70 | $48.70 | |
Cigna
| Professional | $35.07 | $35.07 | $67.45 | |
HMSA
| Professional | $61.32 | $64.20 | $64.20 | |
Kaiser Permanente
| Professional | $36.79 | $61.32 | $85.85 | |
United
| Professional | $42.73 | $48.70 | $67.45 | |
University Health Alliance
| Professional | $49.39 | $53.69 | $444.70 |