| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $216.97 | $245.90 | $315.58 | |
Aetna
| Professional | $218.28 | $218.28 | $218.28 | |
Cigna
| Professional | $148.02 | $315.58 | $315.58 | |
HMSA
| Professional | $339.64 | $425.27 | $495.55 | |
Kaiser Permanente
| Professional | $289.29 | $315.58 | $368.19 | |
United
| Professional | $262.99 | $315.58 | $394.49 | |
University Health Alliance
| Professional | $223.54 | $355.04 | $591.73 |