| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $401.74 | $401.74 | $401.74 | |
Cigna
| Professional | $265.97 | $315.91 | $553.14 | |
HMSA
| Professional | $502.85 | $526.54 | $656.10 | |
Kaiser Permanente
| Professional | $352.00 | $452.57 | $703.99 | |
United
| Professional | $196.99 | $336.20 | $553.14 | |
University Health Alliance
| Professional | $410.74 | $415.59 | $476.32 |