| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $783.75 | $888.25 | $1,140.00 | |
Aetna
| Professional | $503.50 | $503.50 | $503.50 | |
Cigna
| Professional | $1,140.00 | $1,140.00 | $1,140.00 | |
HMSA
| Professional | $950.00 | $994.76 | $1,187.50 | |
Kaiser Permanente
| Professional | $1,045.00 | $1,140.00 | $1,330.00 | |
United
| Professional | $950.00 | $1,140.00 | $1,425.00 |