| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $247.50 | $280.50 | $360.00 | |
Aetna
| Professional | $174.64 | $174.64 | $174.64 | |
Cigna
| Professional | $180.61 | $360.00 | $360.00 | |
HMSA
| Professional | $282.73 | $314.14 | $375.00 | |
Kaiser Permanente
| Professional | $330.00 | $360.00 | $420.00 | |
United
| Professional | $329.51 | $360.00 | $469.55 | |
University Health Alliance
| Professional | $255.00 | $441.00 | $675.00 |