| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $120.99 | $120.99 | $120.99 | |
Cigna
| Facility | $439.01 | $439.01 | $439.01 | |
Cigna
| Professional | $243.89 | $607.88 | $607.88 | |
HMSA
| Professional | $552.62 | $578.66 | $578.66 | |
Kaiser Permanente
| Professional | $331.57 | $552.62 | $773.67 | |
United
| Professional | $271.33 | $439.01 | $607.88 | |
University Health Alliance
| Professional | $241.68 | $445.15 | $525.99 |