| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $193.05 | $218.79 | $280.80 | |
Aetna
| Professional | $82.93 | $82.93 | $82.93 | |
Cigna
| Professional | $280.80 | $280.80 | $280.80 | |
HMSA
| Professional | $83.60 | $208.28 | $245.03 | |
Kaiser Permanente
| Professional | $257.39 | $280.80 | $327.60 | |
United
| Professional | $234.00 | $280.80 | $351.00 | |
University Health Alliance
| Professional | $198.90 | $343.98 | $526.50 |