| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $31.49 | $31.49 | $31.49 | |
Cigna
| Facility | $68.08 | $68.08 | $68.08 | |
Cigna
| Professional | $69.70 | $69.70 | $94.27 | |
HMSA
| Professional | $85.70 | $89.74 | $89.74 | |
Kaiser Permanente
| Professional | $51.42 | $85.70 | $119.98 | |
United
| Professional | $59.72 | $68.08 | $94.27 | |
University Health Alliance
| Professional | $69.03 | $71.40 | $81.56 |