| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $309.38 | $350.63 | $450.00 | |
Aetna
| Professional | $198.75 | $198.75 | $198.75 | |
Cigna
| Professional | $450.00 | $450.00 | $450.00 | |
HMSA
| Professional | $88.50 | $88.50 | $88.50 | |
Kaiser Permanente
| Professional | $412.50 | $450.00 | $525.00 | |
United
| Professional | $375.00 | $450.00 | $562.50 |