| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $287.56 | $325.89 | $418.27 | |
Aetna
| Professional | $227.13 | $227.13 | $227.13 | |
Cigna
| Professional | $418.27 | $418.27 | $418.27 | |
HMSA
| Professional | $398.03 | $437.83 | $547.29 | |
Kaiser Permanente
| Professional | $383.42 | $418.27 | $487.98 | |
United
| Professional | $395.04 | $418.27 | $562.08 | |
University Health Alliance
| Professional | $296.27 | $435.70 | $784.26 |