| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $95.50 | $109.65 | $128.82 | |
Cigna
| Professional | $173.78 | $173.78 | $173.78 | |
HMSA
| Professional | $181.97 | $204.17 | $213.80 | |
Kaiser Permanente
| Professional | $144.54 | $165.96 | $208.93 | |
United
| Professional | $173.78 | $173.78 | $173.78 | |
University Health Alliance
| Professional | $131.83 | $158.49 | $218.78 |