| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $314.89 | $356.89 | $458.04 | |
Aetna
| Professional | $600.00 | $600.00 | $600.00 | |
Cigna
| Professional | $458.04 | $458.04 | $458.04 | |
HMSA
| Professional | $168.15 | $210.19 | $399.69 | |
Kaiser Permanente
| Professional | $419.87 | $458.04 | $534.38 | |
United
| Professional | $151.71 | $458.04 | $572.54 | |
University Health Alliance
| Professional | $324.45 | $515.29 | $1,054.86 |