| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $687.19 | $687.19 | $687.19 | |
Cigna
| Professional | $56.76 | $255.74 | $603.79 | |
HMSA
| Professional | $74.23 | $74.23 | $98.98 | |
Kaiser Permanente
| Professional | $73.62 | $73.62 | $73.62 | |
United
| Professional | $278.39 | $524.02 | $687.19 |