| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.21 | $34.24 | $43.94 | |
Aetna
| Professional | $3.88 | $35.75 | $39.31 | |
Cigna
| Professional | $43.94 | $43.94 | $43.94 | |
HMSA
| Professional | $88.49 | $106.11 | $129.11 | |
Kaiser Permanente
| Professional | $40.28 | $43.94 | $51.27 | |
United
| Professional | $36.61 | $43.94 | $54.93 | |
University Health Alliance
| Professional | $31.13 | $53.83 | $125.83 |