| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $332.96 | $377.36 | $484.31 | |
Aetna
| Professional | $478.53 | $478.53 | $478.53 | |
Cigna
| Professional | $484.31 | $484.31 | $484.31 | |
HMSA
| Professional | $377.42 | $417.50 | $450.90 | |
Kaiser Permanente
| Professional | $443.95 | $484.31 | $565.03 | |
United
| Professional | $301.36 | $484.31 | $605.39 | |
University Health Alliance
| Professional | $343.05 | $527.38 | $737.23 |