| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $630.96 | $758.58 | $933.25 | |
Aetna
| Professional | $416.87 | $602.56 | $741.31 | |
Cigna
| Professional | $933.25 | $933.25 | $933.25 | |
HMSA
| Professional | $776.25 | $912.01 | $954.99 | |
Kaiser Permanente
| Professional | $776.25 | $933.25 | $1,148.15 | |
United
| Professional | $323.59 | $776.25 | $1,148.15 |