| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $372.00 | $421.60 | $541.09 | |
Cigna
| Professional | $541.09 | $541.09 | $541.09 | |
HMSA
| Professional | $424.94 | $509.53 | $563.64 | |
Kaiser Permanente
| Professional | $496.00 | $541.09 | $631.27 | |
United
| Professional | $541.09 | $541.09 | $676.37 |