| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $331.75 | $375.98 | $482.54 | |
Aetna
| Professional | $290.76 | $290.76 | $290.76 | |
Cigna
| Professional | $482.54 | $482.54 | $482.54 | |
HMSA
| Professional | $552.75 | $652.25 | $760.04 | |
Kaiser Permanente
| Professional | $442.33 | $482.54 | $562.97 | |
United
| Professional | $482.54 | $548.60 | $780.59 | |
University Health Alliance
| Professional | $341.80 | $603.46 | $966.65 |