| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.18 | $33.88 | $40.74 | |
Aetna
| Professional | $15.14 | $30.20 | $51.29 | |
Cigna
| Professional | $25.12 | $25.12 | $40.74 | |
HMSA
| Professional | $53.70 | $69.18 | $77.62 | |
Kaiser Permanente
| Professional | $33.88 | $40.74 | $51.29 | |
United
| Professional | $14.45 | $43.65 | $61.66 | |
University Health Alliance
| Professional | $28.84 | $53.70 | $77.62 |