| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.24 | $34.24 | $34.24 | |
Aetna
| Professional | $12.27 | $12.28 | $13.51 | |
Cigna
| Professional | $12.28 | $12.28 | $21.11 | |
HMSA
| Professional | $21.33 | $21.33 | $21.33 | |
Kaiser Permanente
| Professional | $12.28 | $14.74 | $18.43 | |
United
| Professional | $12.28 | $13.55 | $20.55 | |
University Health Alliance
| Professional | $15.84 | $22.10 | $28.64 |