| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $151.36 | $181.97 | $223.87 | |
Aetna
| Professional | $100.00 | $158.49 | $234.42 | |
Cigna
| Professional | $97.72 | $104.71 | $223.87 | |
HMSA
| Professional | $186.21 | $229.09 | $229.09 | |
Kaiser Permanente
| Professional | $204.17 | $223.87 | $275.42 | |
United
| Professional | $93.33 | $186.21 | $275.42 | |
University Health Alliance
| Professional | $158.49 | $251.19 | $416.87 |