| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $415.80 | $471.24 | $604.79 | |
Cigna
| Professional | $604.79 | $604.79 | $604.79 | |
HMSA
| Professional | $448.59 | $527.75 | $630.00 | |
Kaiser Permanente
| Professional | $504.00 | $604.79 | $756.00 | |
United
| Professional | $504.00 | $604.79 | $756.00 | |
University Health Alliance
| Professional | $428.40 | $740.88 | $1,134.00 |