| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $47.89 | $52.34 | $71.80 | |
Cigna
| Professional | $57.84 | $73.41 | $215.08 | |
HMSA
| Professional | $15.71 | $101.26 | $113.85 | |
Kaiser Permanente
| Professional | $60.11 | $68.05 | $79.39 | |
Kaiser Permanente
| Professional | 26 | $12.85 | $14.54 | $16.97 |
United
| Professional | $48.76 | $68.13 | $92.37 | |
University Health Alliance
| Professional | $51.02 | $69.62 | $115.12 |