| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $206.89 | $234.48 | $300.94 | |
Cigna
| Professional | $300.94 | $300.94 | $300.94 | |
HMSA
| Professional | $392.27 | $470.35 | $520.29 | |
Kaiser Permanente
| Professional | $250.78 | $300.94 | $376.17 | |
United
| Professional | $105.33 | $300.94 | $476.95 | |
University Health Alliance
| Professional | $213.16 | $368.65 | $820.02 |