| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.09 | $25.04 | $32.14 | |
Aetna
| Professional | $30.96 | $30.96 | $36.77 | |
Cigna
| Professional | $21.20 | $32.14 | $32.14 | |
HMSA
| Professional | $27.77 | $35.26 | $42.90 | |
Kaiser Permanente
| Professional | $26.78 | $32.14 | $40.17 | |
United
| Professional | $11.25 | $32.14 | $40.17 | |
University Health Alliance
| Professional | $22.76 | $36.15 | $57.86 |