| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $495.00 | $561.00 | $720.00 | |
Aetna
| Professional | $159.72 | $159.72 | $159.72 | |
Cigna
| Professional | $720.00 | $720.00 | $720.00 | |
HMSA
| Professional | $593.72 | $659.69 | $787.50 | |
Kaiser Permanente
| Professional | $660.00 | $720.00 | $840.00 | |
United
| Professional | $301.35 | $452.03 | $720.00 |