| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $267.77 | $303.48 | $389.50 | |
Aetna
| Professional | $194.75 | $194.75 | $194.75 | |
Cigna
| Professional | $177.07 | $389.50 | $389.50 | |
HMSA
| Professional | $332.50 | $392.35 | $457.19 | |
Kaiser Permanente
| Professional | $357.04 | $389.50 | $454.41 | |
United
| Professional | $324.58 | $389.50 | $486.87 | |
University Health Alliance
| Professional | $275.89 | $477.13 | $730.31 |