| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $610.74 | $610.74 | $610.74 | |
Cigna
| Professional | $54.43 | $150.00 | $536.62 | |
HMSA
| Professional | $78.78 | $78.78 | $78.78 | |
Kaiser Permanente
| Professional | $84.70 | $84.70 | $84.70 | |
United
| Professional | $243.50 | $458.34 | $610.74 |