| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $48.98 | $57.54 | $100.00 | |
Cigna
| Professional | $81.28 | $114.82 | $158.49 | |
HMSA
| Professional | $32.36 | $35.48 | $35.48 | |
Kaiser Permanente
| Professional | $97.72 | $107.15 | $125.89 | |
United
| Professional | $45.71 | $131.83 | $162.18 | |
University Health Alliance
| Professional | $19.05 | $32.36 | $35.48 |