| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $162.18 | $162.18 | $162.18 | |
HMSA
| Professional | $173.78 | $173.78 | $173.78 | |
United
| Professional | $154.88 | $190.55 | $245.47 | |
University Health Alliance
| Professional | $134.90 | $134.90 | $158.49 |