| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $154.91 | $154.91 | $154.91 | |
Cigna
| Facility | $410.10 | $410.10 | $410.10 | |
Cigna
| Professional | $306.16 | $306.16 | $567.85 | |
HMSA
| Professional | $516.23 | $540.54 | $540.54 | |
Kaiser Permanente
| Professional | $309.74 | $516.23 | $722.72 | |
United
| Professional | $280.36 | $410.10 | $567.85 | |
University Health Alliance
| Professional | $225.78 | $415.84 | $491.35 |