| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $98.12 | $98.12 | $98.12 | |
Cigna
| Professional | $35.54 | $65.00 | $121.77 | |
HMSA
| Professional | $110.70 | $115.92 | $144.54 | |
Kaiser Permanente
| Professional | $8.84 | $99.63 | $154.97 | |
United
| Professional | $39.04 | $65.66 | $121.77 | |
University Health Alliance
| Professional | $54.68 | $90.60 | $104.91 |