| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $616.14 | $616.14 | $616.14 | |
Cigna
| Professional | $54.03 | $429.00 | $541.37 | |
HMSA
| Professional | $59.14 | $59.14 | $59.14 | |
Kaiser Permanente
| Professional | $94.30 | $94.30 | $94.30 | |
United
| Professional | $241.01 | $453.65 | $616.14 |