| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $159.43 | $180.69 | $231.90 | |
Aetna
| Professional | $102.42 | $102.42 | $102.42 | |
Cigna
| Professional | $105.42 | $231.90 | $231.90 | |
HMSA
| Professional | $193.25 | $222.75 | $246.40 | |
Kaiser Permanente
| Professional | $212.58 | $231.90 | $270.55 | |
United
| Professional | $193.25 | $231.90 | $289.88 | |
University Health Alliance
| Professional | $164.26 | $284.08 | $434.81 |