| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $82.08 | $82.08 | $90.28 | |
Cigna
| Professional | $81.73 | $82.07 | $91.83 | |
HMSA
| Professional | $95.28 | $95.28 | $95.28 | |
Kaiser Permanente
| Professional | $82.08 | $98.49 | $123.11 | |
United
| Professional | $78.06 | $82.08 | $123.12 | |
University Health Alliance
| Professional | $70.76 | $88.45 | $98.72 |