| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $51.86 | $51.86 | $51.86 | |
Cigna
| Facility | $70.97 | $70.97 | $70.97 | |
Cigna
| Professional | $56.56 | $56.56 | $98.27 | |
HMSA
| Professional | $89.34 | $93.55 | $93.55 | |
Kaiser Permanente
| Professional | $53.60 | $89.34 | $125.08 | |
United
| Professional | $62.26 | $88.45 | $98.27 | |
University Health Alliance
| Professional | $39.07 | $71.95 | $85.04 |