| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $594.00 | $673.20 | $864.00 | |
Aetna
| Professional | $292.60 | $292.60 | $292.60 | |
Cigna
| Professional | $864.00 | $864.00 | $864.00 | |
HMSA
| Professional | $720.00 | $720.00 | $900.00 | |
Kaiser Permanente
| Professional | $792.00 | $864.00 | $1,008.00 | |
United
| Professional | $720.00 | $864.00 | $1,080.00 |