| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $158.66 | $179.82 | $230.78 | |
Aetna
| Professional | $323.12 | $323.12 | $323.12 | |
Cigna
| Professional | $230.78 | $230.78 | $230.78 | |
HMSA
| Professional | $181.24 | $217.32 | $240.40 | |
Kaiser Permanente
| Professional | $211.55 | $230.78 | $269.25 | |
United
| Professional | $201.48 | $230.78 | $288.48 | |
University Health Alliance
| Professional | $163.47 | $282.70 | $432.72 |