| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $73.44 | $73.44 | $73.44 | |
Cigna
| Professional | $46.18 | $54.37 | $100.90 | |
HMSA
| Professional | $91.73 | $96.05 | $119.70 | |
Kaiser Permanente
| Professional | $64.20 | $82.56 | $128.41 | |
United
| Professional | $34.53 | $59.85 | $100.90 | |
University Health Alliance
| Professional | $74.93 | $75.81 | $86.89 |