| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $250.71 | $250.71 | $260.83 | |
Cigna
| Facility | $457.54 | $457.54 | $457.54 | |
Cigna
| Professional | $315.73 | $315.73 | $633.54 | |
HMSA
| Professional | $575.95 | $603.09 | $603.09 | |
Kaiser Permanente
| Professional | $345.57 | $575.95 | $806.33 | |
United
| Professional | $322.02 | $457.54 | $633.54 | |
University Health Alliance
| Professional | $251.87 | $463.95 | $548.20 |