| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $94.41 | $94.41 | $94.41 | |
Cigna
| Professional | $109.51 | $139.31 | $170.73 | |
HMSA
| Professional | $152.88 | $179.66 | $251.05 | |
Kaiser Permanente
| Professional | $136.58 | $163.90 | $191.21 | |
United
| Professional | $141.90 | $170.73 | $246.21 | |
University Health Alliance
| Professional | $146.07 | $146.07 | $154.50 |