| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $304.54 | $304.54 | $304.54 | |
Cigna
| Professional | $35.88 | $219.78 | $355.62 | |
HMSA
| Professional | $444.90 | $465.86 | $588.00 | |
Kaiser Permanente
| Professional | $351.06 | $351.06 | $351.06 | |
United
| Professional | $194.80 | $304.54 | $366.67 | |
University Health Alliance
| Professional | $369.54 | $369.54 | $444.90 |