| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $230.26 | $230.26 | $230.26 | |
Cigna
| Facility | $537.33 | $537.33 | $537.33 | |
Cigna
| Professional | $386.84 | $386.84 | $744.03 | |
HMSA
| Professional | $676.39 | $708.26 | $708.26 | |
Kaiser Permanente
| Professional | $405.83 | $676.39 | $946.95 | |
United
| Professional | $471.37 | $537.33 | $744.03 | |
University Health Alliance
| Professional | $295.80 | $544.86 | $643.79 |