| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $94.30 | $94.30 | $94.30 | |
Cigna
| Professional | $60.46 | $71.44 | $120.37 | |
HMSA
| Professional | $109.43 | $114.59 | $142.85 | |
Kaiser Permanente
| Professional | $76.59 | $98.49 | $153.19 | |
United
| Professional | $45.06 | $77.93 | $120.37 | |
University Health Alliance
| Professional | $90.15 | $95.23 | $103.69 |