| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $90.33 | $102.37 | $131.38 | |
Cigna
| Professional | $63.61 | $131.38 | $131.38 | |
HMSA
| Professional | $97.45 | $116.34 | $129.19 | |
Kaiser Permanente
| Professional | $109.49 | $131.38 | $164.24 | |
United
| Professional | $45.99 | $131.38 | $164.24 | |
University Health Alliance
| Professional | $93.07 | $129.19 | $191.61 |