| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $28.95 | $28.95 | $28.95 | |
Cigna
| Professional | $58.46 | $68.42 | $308.95 | |
HMSA
| Professional | $30.93 | $415.93 | $511.23 | |
Kaiser Permanente
| Professional | $47.63 | $51.96 | $54.13 | |
United
| Professional | $58.46 | $71.63 | $237.48 | |
University Health Alliance
| Professional | $55.14 | $76.68 | $382.74 |