| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $425.71 | $425.71 | $425.71 | |
Cigna
| Facility | $386.21 | $386.21 | $386.21 | |
Cigna
| Professional | $278.04 | $278.04 | $534.79 | |
HMSA
| Professional | $486.17 | $509.08 | $509.08 | |
Kaiser Permanente
| Professional | $291.70 | $486.17 | $680.64 | |
United
| Facility | $220.01 | $220.01 | $284.23 | |
United
| Professional | $295.04 | $454.57 | $534.79 | |
University Health Alliance
| Professional | $347.95 | $405.05 | $462.75 |