| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $338.17 | $383.26 | $491.88 | |
Aetna
| Professional | $241.39 | $241.39 | $241.39 | |
Cigna
| Professional | $491.88 | $491.88 | $491.88 | |
HMSA
| Professional | $563.45 | $664.87 | $774.75 | |
Kaiser Permanente
| Professional | $450.89 | $491.88 | $573.86 | |
United
| Professional | $455.45 | $614.85 | $614.85 |