| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $143.75 | $175.28 | $175.28 | |
Cigna
| Professional | $127.26 | $148.66 | $178.12 | |
HMSA
| Professional | $126.00 | $131.94 | $131.94 | |
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 | |
United
| Professional | $108.17 | $127.26 | $127.26 | |
University Health Alliance
| Professional | $112.20 | $112.20 | $112.20 |