| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.95 | $22.39 | $54.95 | |
Aetna
| Professional | $16.98 | $20.89 | $23.99 | |
Cigna
| Professional | $19.05 | $19.05 | $19.05 | |
HMSA
| Professional | $36.31 | $51.29 | $52.48 | |
Kaiser Permanente
| Professional | $23.99 | $28.84 | $36.31 | |
United
| Professional | $10.00 | $33.88 | $36.31 | |
University Health Alliance
| Professional | $37.15 | $45.71 | $61.66 |