| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $278.63 | $315.77 | $405.28 | |
Aetna
| Professional | $66.48 | $66.48 | $66.48 | |
Cigna
| Professional | $405.28 | $405.28 | $405.28 | |
HMSA
| Professional | $143.56 | $179.45 | $353.64 | |
Kaiser Permanente
| Professional | $371.50 | $405.28 | $472.82 | |
United
| Professional | $129.53 | $405.28 | $506.60 | |
University Health Alliance
| Professional | $125.88 | $378.26 | $607.91 |