| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $312.74 | $312.74 | $312.74 | |
Cigna
| Facility | $451.94 | $451.94 | $451.94 | |
Cigna
| Professional | $325.37 | $325.37 | $625.79 | |
HMSA
| Professional | $568.90 | $595.71 | $595.71 | |
Kaiser Permanente
| Professional | $341.34 | $568.90 | $796.46 | |
United
| Professional | $345.29 | $531.91 | $625.79 | |
University Health Alliance
| Professional | $458.27 | $473.98 | $541.49 |