| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $314.08 | $355.97 | $456.86 | |
Cigna
| Professional | $456.86 | $456.86 | $456.86 | |
HMSA
| Professional | $89.85 | $89.85 | $89.85 | |
Kaiser Permanente
| Professional | $380.72 | $456.86 | $571.08 | |
United
| Professional | $159.90 | $456.86 | $571.08 |