| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $245.60 | $245.60 | $245.60 | |
Cigna
| Facility | $776.68 | $776.68 | $776.68 | |
Cigna
| Professional | $564.36 | $564.36 | $1,075.43 | |
HMSA
| Professional | $977.66 | $1,023.73 | $1,023.73 | |
Kaiser Permanente
| Professional | $586.60 | $977.66 | $1,368.72 | |
United
| Professional | $468.37 | $776.68 | $1,075.43 | |
University Health Alliance
| Professional | $787.55 | $814.54 | $930.56 |