| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $826.94 | $826.94 | $826.94 | |
Cigna
| Professional | $432.02 | $432.02 | $432.02 | |
HMSA
| Professional | $576.16 | $576.16 | $576.16 | |
Kaiser Permanente
| Professional | $475.22 | $518.42 | $604.83 | |
United
| Professional | $432.02 | $473.55 | $648.03 | |
University Health Alliance
| Professional | $65.50 | $449.30 | $562.95 |