| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $148.19 | $148.19 | $148.19 | |
Cigna
| Facility | $438.81 | $438.81 | $438.81 | |
Cigna
| Professional | $260.88 | $260.88 | $607.61 | |
HMSA
| Professional | $552.37 | $578.40 | $578.40 | |
Kaiser Permanente
| Professional | $331.42 | $552.37 | $773.32 | |
United
| Professional | $307.88 | $438.81 | $607.61 | |
University Health Alliance
| Professional | $241.58 | $444.95 | $525.75 |