| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $825.54 | $825.54 | $825.54 | |
Cigna
| Professional | $200.00 | $200.00 | $725.35 | |
Kaiser Permanente
| Professional | $63.11 | $63.11 | $63.11 | |
United
| Professional | $380.98 | $717.10 | $825.54 | |
University Health Alliance
| Professional | $805.61 | $805.61 | $805.61 |