| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $60.04 | $60.04 | $62.47 | |
Cigna
| Facility | $72.06 | $72.06 | $72.06 | |
Cigna
| Professional | $61.21 | $61.21 | $99.78 | |
HMSA
| Professional | $90.71 | $94.98 | $94.98 | |
Kaiser Permanente
| Professional | $63.50 | $90.71 | $126.99 | |
United
| Professional | $70.47 | $84.81 | $99.78 | |
University Health Alliance
| Professional | $49.70 | $73.08 | $86.34 |