| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.00 | $23.80 | $30.54 | |
Cigna
| Professional | $30.54 | $30.54 | $30.54 | |
HMSA
| Professional | $39.07 | $49.61 | $60.36 | |
Kaiser Permanente
| Professional | $25.45 | $30.54 | $38.18 | |
United
| Professional | $10.69 | $30.54 | $38.18 | |
University Health Alliance
| Professional | $21.63 | $34.36 | $57.26 |