| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $100.39 | $100.39 | $100.39 | |
Cigna
| Professional | $78.94 | $87.04 | $139.01 | |
HMSA
| Professional | $126.37 | $132.32 | $166.83 | |
Kaiser Permanente
| Professional | $9.03 | $113.73 | $176.92 | |
United
| Professional | $60.01 | $100.39 | $139.01 | |
University Health Alliance
| Professional | $105.07 | $105.60 | $111.22 |