| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $560.65 | $635.40 | $815.48 | |
Aetna
| Professional | $360.17 | $360.17 | $360.17 | |
Cigna
| Professional | $815.48 | $815.48 | $815.48 | |
HMSA
| Professional | $604.85 | $711.59 | $849.46 | |
Kaiser Permanente
| Professional | $679.57 | $815.48 | $1,019.36 | |
United
| Professional | $679.57 | $815.48 | $1,019.36 | |
University Health Alliance
| Professional | $577.63 | $998.97 | $1,529.03 |