| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $415.31 | $470.68 | $604.08 | |
Cigna
| Professional | $604.08 | $604.08 | $604.08 | |
HMSA
| Professional | $503.40 | $503.40 | $527.12 | |
Kaiser Permanente
| Professional | $503.40 | $604.08 | $755.10 | |
United
| Professional | $503.40 | $604.08 | $604.08 |