| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $152.79 | $173.16 | $222.24 | |
Aetna
| Professional | $98.16 | $98.16 | $98.16 | |
Cigna
| Professional | $100.90 | $222.24 | $222.24 | |
HMSA
| Professional | $185.20 | $218.54 | $254.65 | |
Kaiser Permanente
| Professional | $203.72 | $222.24 | $259.27 | |
United
| Professional | $185.20 | $277.80 | $277.80 | |
University Health Alliance
| Professional | $157.41 | $250.02 | $416.70 |