| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.89 | $22.54 | $28.93 | |
Aetna
| Professional | $21.08 | $21.08 | $21.08 | |
Cigna
| Professional | $14.33 | $28.93 | $28.93 | |
HMSA
| Professional | $29.36 | $38.72 | $45.33 | |
Kaiser Permanente
| Professional | $24.11 | $28.93 | $36.17 | |
United
| Professional | $10.13 | $28.93 | $36.17 | |
University Health Alliance
| Professional | $27.46 | $42.19 | $54.25 |