| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $524.81 | $630.96 | $776.25 | |
Aetna
| Professional | $346.74 | $501.19 | $616.60 | |
Cigna
| Professional | $776.25 | $776.25 | $776.25 | |
HMSA
| Professional | $645.65 | $758.58 | $794.33 | |
Kaiser Permanente
| Professional | $645.65 | $776.25 | $954.99 | |
United
| Professional | $269.15 | $645.65 | $954.99 |