| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $495.00 | $561.00 | $720.00 | |
Aetna
| Professional | $318.00 | $318.00 | $318.00 | |
Cigna
| Professional | $327.25 | $720.00 | $720.00 | |
HMSA
| Professional | $605.24 | $714.18 | $832.20 | |
Kaiser Permanente
| Professional | $660.00 | $720.00 | $840.00 | |
United
| Professional | $600.00 | $720.00 | $900.00 | |
University Health Alliance
| Professional | $510.00 | $810.00 | $1,350.00 |