| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $22.53 | $22.53 | $22.53 | |
Cigna
| Facility | $36.83 | $36.83 | $36.83 | |
Cigna
| Professional | $29.97 | $51.01 | $51.01 | |
HMSA
| Professional | $46.37 | $48.55 | $48.55 | |
Kaiser Permanente
| Professional | $27.82 | $46.37 | $64.92 | |
United
| Professional | $29.97 | $36.83 | $51.01 | |
University Health Alliance
| Professional | $20.27 | $37.35 | $44.13 |