| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $24.58 | $26.01 | $36.43 | |
Cigna
| Professional | $22.14 | $38.86 | $109.73 | |
HMSA
| Professional | $41.07 | $44.55 | $53.19 | |
Kaiser Permanente
| Professional | $43.71 | $45.70 | $49.68 | |
United
| Professional | $31.89 | $41.87 | $62.33 | |
University Health Alliance
| Professional | $34.95 | $53.63 | $250.00 |