| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $493.28 | $559.04 | $717.49 | |
Aetna
| Professional | $316.89 | $316.89 | $316.89 | |
Cigna
| Professional | $717.49 | $717.49 | $717.49 | |
HMSA
| Professional | $567.41 | $680.37 | $752.63 | |
Kaiser Permanente
| Professional | $657.70 | $717.49 | $837.07 | |
United
| Professional | $597.91 | $717.49 | $896.87 |