| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $557.21 | $631.50 | $810.48 | |
Aetna
| Professional | $650.00 | $650.00 | $650.00 | |
Cigna
| Professional | $810.48 | $810.48 | $810.48 | |
HMSA
| Professional | $675.40 | $716.23 | $895.29 | |
Kaiser Permanente
| Professional | $742.94 | $810.48 | $945.56 | |
United
| Professional | $646.24 | $810.48 | $1,013.10 | |
University Health Alliance
| Professional | $574.09 | $992.84 | $1,519.65 |