| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $71.65 | $71.65 | $71.65 | |
Cigna
| Professional | $48.02 | $56.29 | $98.30 | |
HMSA
| Professional | $89.36 | $93.57 | $116.60 | |
Kaiser Permanente
| Professional | $62.55 | $80.42 | $125.10 | |
United
| Professional | $35.29 | $60.04 | $98.30 | |
University Health Alliance
| Professional | $73.00 | $73.86 | $77.73 |