| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $32.59 | $32.59 | $32.59 | |
Cigna
| Facility | $76.04 | $76.04 | $76.04 | |
Cigna
| Professional | $66.58 | $66.58 | $105.29 | |
HMSA
| Professional | $95.72 | $100.23 | $100.23 | |
Kaiser Permanente
| Professional | $57.43 | $95.72 | $134.01 | |
United
| Professional | $58.10 | $76.04 | $105.29 | |
University Health Alliance
| Professional | $66.70 | $79.75 | $91.11 |