| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $244.03 | $276.56 | $354.95 | |
Aetna
| Professional | $156.77 | $156.77 | $156.77 | |
Cigna
| Professional | $161.37 | $354.95 | $354.95 | |
HMSA
| Professional | $278.76 | $334.24 | $369.74 | |
Kaiser Permanente
| Professional | $325.37 | $354.95 | $414.11 | |
United
| Professional | $295.79 | $354.95 | $443.69 | |
University Health Alliance
| Professional | $251.42 | $434.81 | $665.53 |