| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $214.91 | $243.57 | $312.60 | |
Aetna
| Professional | $138.07 | $138.07 | $138.07 | |
Cigna
| Professional | $312.60 | $312.60 | $312.60 | |
HMSA
| Professional | $231.85 | $272.77 | $325.63 | |
Kaiser Permanente
| Professional | $260.50 | $312.60 | $390.75 | |
United
| Professional | $260.50 | $312.60 | $390.75 | |
University Health Alliance
| Professional | $221.43 | $382.94 | $586.13 |