| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.54 | $21.54 | $21.54 | |
Cigna
| Professional | $9.42 | $9.42 | $9.42 | |
HMSA
| Professional | $19.37 | $24.59 | $28.46 | |
Kaiser Permanente
| Professional | $21.76 | $26.11 | $32.64 | |
United
| Professional | $9.14 | $26.11 | $32.64 | |
University Health Alliance
| Professional | $26.31 | $29.33 | $31.01 |