| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $239.17 | $239.17 | $239.17 | |
Aetna
| Professional | $79.16 | $145.16 | $281.76 | |
Cigna
| Professional | $89.21 | $144.62 | $209.59 | |
HMSA
| Professional | $145.44 | $161.60 | $190.97 | |
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 | |
United
| Professional | $117.01 | $167.47 | $213.84 | |
University Health Alliance
| Professional | $94.82 | $189.64 | $361.26 |