| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.28 | $58.28 | $99.45 | |
Cigna
| Professional | $137.36 | $137.36 | $137.36 | |
HMSA
| Professional | $136.00 | $142.41 | $142.41 | |
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 | |
United
| Professional | $116.76 | $137.36 | $137.36 | |
University Health Alliance
| Professional | $149.60 | $149.60 | $149.60 |