| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $215.88 | $215.88 | $215.88 | |
Cigna
| Facility | $545.00 | $545.00 | $545.00 | |
Cigna
| Professional | $215.87 | $215.87 | $754.64 | |
HMSA
| Professional | $686.04 | $718.37 | $718.37 | |
Kaiser Permanente
| Professional | $411.62 | $686.04 | $960.46 | |
United
| Professional | $263.75 | $545.00 | $754.64 | |
University Health Alliance
| Professional | $300.02 | $552.63 | $652.98 |