| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $626.61 | $710.16 | $911.44 | |
Aetna
| Professional | $719.07 | $719.07 | $719.07 | |
Cigna
| Professional | $911.44 | $911.44 | $911.44 | |
HMSA
| Professional | $676.02 | $795.32 | $949.41 | |
Kaiser Permanente
| Professional | $759.53 | $911.44 | $1,139.30 | |
United
| Professional | $319.00 | $911.44 | $1,139.30 | |
University Health Alliance
| Professional | $645.60 | $1,116.51 | $1,708.94 |