| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $79.03 | $79.03 | $104.32 | |
Cigna
| Professional | $75.97 | $75.97 | $75.97 | |
HMSA
| Professional | $107.34 | $107.34 | $107.34 | |
Kaiser Permanente
| Professional | $83.57 | $91.17 | $106.36 | |
United
| Professional | $75.97 | $75.97 | $113.96 | |
University Health Alliance
| Professional | $88.96 | $88.96 | $94.84 |