| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $489.78 | $588.84 | $724.44 | |
Aetna
| Professional | $162.18 | $467.74 | $575.44 | |
Cigna
| Professional | $724.44 | $724.44 | $724.44 | |
HMSA
| Professional | $630.96 | $741.31 | $794.33 | |
Kaiser Permanente
| Professional | $660.69 | $724.44 | $891.25 | |
United
| Professional | $151.36 | $302.00 | $724.44 |