| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $558.01 | $632.41 | $811.64 | |
Cigna
| Professional | $811.64 | $811.64 | $811.64 | |
HMSA
| Professional | $637.41 | $764.30 | $845.46 | |
Kaiser Permanente
| Professional | $744.01 | $811.64 | $946.92 | |
United
| Professional | $676.37 | $811.64 | $1,014.56 |