| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.91 | $25.91 | $61.81 | |
Cigna
| Professional | $34.15 | $92.09 | $92.09 | |
HMSA
| Professional | $83.72 | $87.66 | $87.66 | |
Kaiser Permanente
| Professional | $117.21 | $117.21 | $117.21 | |
United
| Professional | $35.50 | $92.09 | $152.59 | |
University Health Alliance
| Professional | $34.42 | $70.23 | $108.00 |