| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $144.61 | $144.61 | $144.61 | |
Cigna
| Facility | $324.01 | $324.01 | $324.01 | |
Cigna
| Professional | $278.10 | $278.10 | $426.14 | |
HMSA
| Professional | $387.40 | $405.65 | $405.65 | |
Kaiser Permanente
| Professional | $271.18 | $387.40 | $542.36 | |
United
| Professional | $203.47 | $362.22 | $426.14 | |
University Health Alliance
| Professional | $328.54 | $339.80 | $372.23 |