| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.16 | $85.39 | $85.39 | |
Aetna
| Professional | $14.40 | $24.91 | $88.11 | |
Cigna
| Facility | $41.16 | $41.16 | $75.54 | |
Cigna
| Professional | $35.28 | $65.06 | $107.04 | |
HMSA
| Professional | $31.03 | $37.38 | $45.81 | |
Kaiser Permanente
| Professional | $37.88 | $39.61 | $43.05 | |
United
| Professional | $27.22 | $37.20 | $56.18 | |
University Health Alliance
| Professional | $30.57 | $44.93 | $250.00 |