| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.84 | $34.67 | $41.69 | |
Aetna
| Professional | $1.35 | $28.18 | $43.65 | |
Cigna
| Professional | $41.69 | $41.69 | $41.69 | |
HMSA
| Professional | $74.13 | $95.50 | $107.15 | |
Kaiser Permanente
| Professional | $38.90 | $41.69 | $52.48 | |
United
| Professional | $17.38 | $34.67 | $52.48 | |
University Health Alliance
| Professional | $29.51 | $51.29 | $100.00 |