| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $149.22 | $149.22 | $149.22 | |
Cigna
| Facility | $486.31 | $486.31 | $486.31 | |
Cigna
| Professional | $312.30 | $312.30 | $563.04 | |
HMSA
| Professional | $511.85 | $535.97 | $535.97 | |
Kaiser Permanente
| Professional | $358.30 | $511.85 | $716.59 | |
United
| Professional | $75.48 | $486.31 | $563.04 | |
University Health Alliance
| Professional | $459.20 | $470.22 | $493.12 |