| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $192.28 | $217.92 | $279.68 | |
Aetna
| Professional | $450.00 | $450.00 | $450.00 | |
Cigna
| Professional | $279.68 | $279.68 | $279.68 | |
HMSA
| Professional | $295.60 | $348.81 | $406.45 | |
Kaiser Permanente
| Professional | $256.38 | $279.68 | $326.30 | |
United
| Professional | $279.68 | $349.61 | $349.61 | |
University Health Alliance
| Professional | $198.11 | $342.61 | $717.70 |