| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $57.53 | $57.54 | $63.29 | |
Cigna
| Professional | $58.93 | $58.93 | $85.51 | |
HMSA
| Professional | $51.09 | $51.09 | $130.00 | |
Kaiser Permanente
| Professional | $72.45 | $79.03 | $82.33 | |
United
| Professional | $57.78 | $85.51 | $86.67 | |
University Health Alliance
| Professional | $73.89 | $73.89 | $73.89 |