| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $14.40 | $20.93 | $30.91 | |
Cigna
| Professional | $14.15 | $34.60 | $42.40 | |
HMSA
| Professional | $30.77 | $35.24 | $38.46 | |
Kaiser Permanente
| Professional | $37.31 | $37.31 | $42.40 | |
United
| Professional | $26.95 | $34.60 | $53.46 | |
University Health Alliance
| Professional | $29.45 | $43.68 | $250.00 |