| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $612.37 | $694.02 | $890.72 | |
Aetna
| Professional | $393.40 | $393.40 | $393.40 | |
Cigna
| Professional | $890.72 | $890.72 | $890.72 | |
HMSA
| Professional | $699.53 | $838.77 | $927.84 | |
Kaiser Permanente
| Professional | $816.50 | $890.72 | $1,039.18 | |
United
| Professional | $742.27 | $890.72 | $1,113.41 |