| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $268.24 | $268.24 | $268.24 | |
Cigna
| Professional | $140.99 | $140.99 | $140.99 | |
HMSA
| Professional | $199.26 | $199.26 | $199.26 | |
Kaiser Permanente
| Professional | $155.09 | $169.19 | $197.39 | |
United
| Professional | $156.94 | $163.78 | $211.49 | |
University Health Alliance
| Professional | $132.76 | $165.14 | $176.06 |