| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $140.75 | $140.75 | $154.15 | |
Cigna
| Professional | $161.82 | $161.82 | $161.82 | |
HMSA
| Professional | $211.64 | $211.64 | $211.64 | |
Kaiser Permanente
| Professional | $154.83 | $168.90 | $197.05 | |
United
| Professional | $168.90 | $173.08 | $216.72 | |
University Health Alliance
| Professional | $119.64 | $119.64 | $140.75 |