| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.80 | $16.00 | $52.80 | |
Aetna
| Professional | $17.64 | $17.64 | $17.64 | |
HMSA
| Professional | $19.04 | $19.94 | $19.94 | |
Kaiser Permanente
| Professional | $3.43 | $3.43 | $3.43 | |
United
| Professional | $3.38 | $4.99 | $9.44 | |
University Health Alliance
| Professional | $9.94 | $9.94 | $9.94 |