| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $61.24 | $92.39 | $360.00 | |
Cigna
| Professional | $71.66 | $112.71 | $166.18 | |
HMSA
| Professional | $112.29 | $124.77 | $149.50 | |
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 | |
United
| Professional | $87.00 | $133.40 | $171.60 | |
University Health Alliance
| Professional | $61.98 | $116.52 | $255.27 |