| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $226.73 | $256.97 | $329.80 | |
Aetna
| Professional | $145.66 | $145.66 | $145.66 | |
Cigna
| Professional | $149.79 | $329.80 | $329.80 | |
HMSA
| Professional | $274.83 | $324.30 | $377.89 | |
Kaiser Permanente
| Professional | $302.31 | $329.80 | $384.76 | |
United
| Professional | $274.83 | $329.80 | $412.25 | |
University Health Alliance
| Professional | $233.61 | $371.02 | $618.37 |