| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $120.65 | $120.65 | $120.65 | |
HMSA
| Professional | $110.43 | $124.07 | $129.91 | |
Kaiser Permanente
| Professional | $106.02 | $115.82 | $135.13 | |
United
| Professional | $120.65 | $120.65 | $157.31 | |
University Health Alliance
| Professional | $85.74 | $119.03 | $142.19 |