| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $142.87 | $161.91 | $207.80 | |
Aetna
| Professional | $134.01 | $134.01 | $134.01 | |
Cigna
| Professional | $137.41 | $207.80 | $207.80 | |
HMSA
| Professional | $298.80 | $352.58 | $410.85 | |
Kaiser Permanente
| Professional | $190.49 | $207.80 | $242.44 | |
United
| Professional | $207.80 | $259.76 | $336.16 | |
University Health Alliance
| Professional | $193.95 | $312.13 | $435.53 |