| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $528.60 | $599.08 | $768.88 | |
Cigna
| Professional | $768.88 | $768.88 | $768.88 | |
HMSA
| Professional | $570.28 | $670.92 | $800.91 | |
Kaiser Permanente
| Professional | $640.73 | $768.88 | $961.10 | |
United
| Professional | $269.11 | $768.88 | $961.10 |