| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $384.59 | $435.87 | $559.40 | |
Aetna
| Professional | $247.07 | $247.07 | $247.07 | |
Cigna
| Professional | $559.40 | $559.40 | $559.40 | |
HMSA
| Professional | $443.31 | $531.54 | $646.79 | |
Kaiser Permanente
| Professional | $512.79 | $559.40 | $652.64 | |
United
| Professional | $466.17 | $559.40 | $699.26 |