| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.78 | $5.78 | $32.00 | |
Cigna
| Facility | $21.81 | $21.81 | $21.81 | |
Cigna
| Professional | $16.09 | $16.09 | $30.20 | |
HMSA
| Professional | $27.45 | $28.74 | $28.74 | |
Kaiser Permanente
| Professional | $16.47 | $27.45 | $38.43 | |
United
| Professional | $12.61 | $21.81 | $30.20 | |
University Health Alliance
| Professional | $18.76 | $22.87 | $26.13 |