| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.32 | $26.43 | $33.92 | |
Aetna
| Professional | $29.67 | $29.67 | $29.67 | |
Cigna
| Professional | $33.92 | $33.92 | $33.92 | |
HMSA
| Professional | $43.41 | $55.11 | $67.06 | |
Kaiser Permanente
| Professional | $28.27 | $33.92 | $42.41 | |
United
| Professional | $11.87 | $33.92 | $42.41 | |
University Health Alliance
| Professional | $38.39 | $38.39 | $38.39 |