| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $626.22 | $709.71 | $910.86 | |
Aetna
| Professional | $570.79 | $580.79 | $749.00 | |
Cigna
| Professional | $910.86 | $910.86 | $910.86 | |
HMSA
| Professional | $732.96 | $862.30 | $1,029.38 | |
Kaiser Permanente
| Professional | $759.05 | $910.86 | $1,138.58 | |
United
| Professional | $802.33 | $910.86 | $1,138.58 | |
University Health Alliance
| Professional | $645.19 | $1,115.80 | $1,707.86 |