| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $160.44 | $160.44 | $160.44 | |
Cigna
| Facility | $346.84 | $346.84 | $346.84 | |
Cigna
| Professional | $318.35 | $318.35 | $480.26 | |
HMSA
| Professional | $436.60 | $457.17 | $457.17 | |
Kaiser Permanente
| Professional | $261.95 | $436.60 | $611.24 | |
United
| Professional | $304.26 | $432.23 | $480.26 | |
University Health Alliance
| Professional | $351.70 | $363.76 | $415.57 |