| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $17.61 | $17.61 | $17.61 | |
Cigna
| Facility | $37.67 | $37.67 | $37.67 | |
Cigna
| Professional | $26.04 | $26.04 | $52.16 | |
HMSA
| Professional | $47.42 | $49.65 | $49.65 | |
Kaiser Permanente
| Professional | $28.45 | $47.42 | $66.39 | |
United
| Professional | $22.43 | $37.67 | $52.16 | |
University Health Alliance
| Professional | $32.36 | $39.51 | $45.14 |