| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $416.87 | $501.19 | $616.60 | |
Aetna
| Professional | $275.42 | $478.63 | $645.65 | |
Cigna
| Professional | $263.03 | $281.84 | $616.60 | |
HMSA
| Professional | $512.86 | $602.56 | $630.96 | |
Kaiser Permanente
| Professional | $562.34 | $616.60 | $758.58 | |
United
| Professional | $257.04 | $512.86 | $758.58 | |
University Health Alliance
| Professional | $436.52 | $794.33 | $1,230.27 |