| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $226.73 | $256.97 | $329.80 | |
Aetna
| Professional | $10.53 | $10.53 | $10.53 | |
Cigna
| Professional | $329.80 | $329.80 | $329.80 | |
HMSA
| Professional | $259.00 | $310.56 | $343.54 | |
Kaiser Permanente
| Professional | $302.31 | $329.80 | $384.76 | |
United
| Professional | $274.83 | $329.80 | $412.25 | |
University Health Alliance
| Professional | $192.38 | $343.54 | $494.69 |