| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.14 | $30.14 | $30.14 | |
Cigna
| Facility | $30.13 | $30.13 | $30.13 | |
Cigna
| Professional | $15.04 | $15.04 | $15.04 | |
HMSA
| Professional | $21.94 | $21.94 | $21.94 | |
Kaiser Permanente
| Professional | $16.55 | $18.05 | $21.06 | |
United
| Professional | $15.04 | $18.04 | $22.56 | |
University Health Alliance
| Professional | $15.09 | $18.23 | $19.47 |