| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $290.62 | $600.00 | $1,253.14 | |
Cigna
| Professional | $227.42 | $554.05 | $2,462.71 | |
Kaiser Permanente
| Professional | $230.71 | $251.69 | $293.64 | |
United
| Facility | $2,446.00 | $2,446.00 | $2,446.00 | |
United
| Professional | $267.47 | $469.18 | $829.54 | |
University Health Alliance
| Professional | $31.50 | $167.37 | $252.03 |