| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $206.78 | $206.78 | $206.78 | |
Cigna
| Facility | $382.23 | $382.23 | $382.23 | |
Cigna
| Professional | $379.04 | $529.25 | $529.25 | |
HMSA
| Professional | $481.14 | $503.81 | $503.81 | |
Kaiser Permanente
| Professional | $288.68 | $481.14 | $673.60 | |
United
| Professional | $335.31 | $432.24 | $529.25 | |
University Health Alliance
| Professional | $210.42 | $387.58 | $457.95 |