| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $450.61 | $450.61 | $450.61 | |
Cigna
| Facility | $753.96 | $753.96 | $753.96 | |
Cigna
| Professional | $488.53 | $488.53 | $1,043.99 | |
HMSA
| Professional | $949.08 | $993.80 | $993.80 | |
Kaiser Permanente
| Professional | $569.45 | $949.08 | $1,328.71 | |
United
| Professional | $599.61 | $939.59 | $1,043.99 | |
University Health Alliance
| Professional | $679.28 | $790.72 | $903.35 |