| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $114.82 | $173.78 | $269.15 | |
Cigna
| Professional | $158.49 | $251.19 | $380.19 | |
HMSA
| Professional | $213.80 | $234.42 | $288.40 | |
Kaiser Permanente
| Professional | $173.78 | $186.21 | $218.78 | |
United
| Professional | $204.17 | $223.87 | $316.23 | |
University Health Alliance
| Professional | $162.18 | $229.09 | $389.05 |