| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $32.36 | $38.90 | $46.77 | |
Aetna
| Professional | $4.79 | $36.31 | $83.18 | |
Cigna
| Professional | $46.77 | $46.77 | $46.77 | |
HMSA
| Professional | $93.33 | $120.23 | $134.90 | |
Kaiser Permanente
| Professional | $43.65 | $46.77 | $58.88 | |
United
| Professional | $19.50 | $38.90 | $58.88 | |
University Health Alliance
| Professional | $33.11 | $57.54 | $125.89 |