| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $925.74 | $925.74 | $925.74 | |
Cigna
| Professional | $495.55 | $495.55 | $495.55 | |
HMSA
| Professional | $707.22 | $707.22 | $707.22 | |
Kaiser Permanente
| Professional | $545.10 | $594.65 | $693.76 | |
United
| Professional | $495.55 | $581.28 | $743.33 | |
University Health Alliance
| Professional | $462.87 | $578.59 | $624.88 |