| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $266.44 | $301.97 | $387.55 | |
Cigna
| Professional | $387.55 | $387.55 | $387.55 | |
HMSA
| Professional | $495.94 | $629.64 | $766.15 | |
Kaiser Permanente
| Professional | $322.95 | $387.55 | $484.44 | |
United
| Professional | $135.63 | $387.55 | $484.44 |