| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $430.44 | $430.44 | $430.44 | |
Cigna
| Professional | $35.75 | $332.93 | $432.99 | |
HMSA
| Professional | $539.10 | $564.50 | $703.35 | |
Kaiser Permanente
| Professional | $427.44 | $427.44 | $427.44 | |
United
| Professional | $202.09 | $202.09 | $430.44 | |
University Health Alliance
| Professional | $539.10 | $539.10 | $539.10 |