| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.50 | $33.01 | $116.14 | |
Cigna
| Professional | $33.50 | $33.50 | $33.50 | |
HMSA
| Professional | $26.20 | $31.69 | $36.03 | |
Kaiser Permanente
| Professional | $22.20 | $24.22 | $28.25 | |
United
| Professional | $25.23 | $28.58 | $35.00 | |
University Health Alliance
| Professional | $23.88 | $31.09 | $199.23 |