| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $276.69 | $313.58 | $402.46 | |
Aetna
| Professional | $242.50 | $242.50 | $242.50 | |
Cigna
| Professional | $402.46 | $402.46 | $402.46 | |
HMSA
| Professional | $461.00 | $543.98 | $633.88 | |
Kaiser Permanente
| Professional | $368.92 | $402.46 | $469.53 | |
United
| Professional | $402.46 | $457.54 | $651.03 | |
University Health Alliance
| Professional | $285.07 | $452.76 | $754.61 |