| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $165.96 | $199.53 | $239.88 | |
Aetna
| Professional | $128.82 | $154.88 | $194.98 | |
Cigna
| Professional | $239.88 | $239.88 | $239.88 | |
HMSA
| Professional | $46.77 | $46.77 | $46.77 | |
Kaiser Permanente
| Professional | $218.78 | $239.88 | $302.00 | |
United
| Professional | $100.00 | $199.53 | $302.00 |