| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $247.14 | $247.14 | $247.14 | |
Cigna
| Facility | $565.62 | $565.62 | $565.62 | |
Cigna
| Professional | $436.96 | $436.96 | $783.19 | |
HMSA
| Professional | $711.99 | $745.54 | $745.54 | |
Kaiser Permanente
| Professional | $427.19 | $711.99 | $996.79 | |
United
| Professional | $463.61 | $565.62 | $783.19 | |
University Health Alliance
| Professional | $311.37 | $573.54 | $677.68 |