| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,445.44 | $1,737.80 | $2,089.30 | |
Aetna
| Professional | $602.56 | $1,047.13 | $1,513.56 | |
Cigna
| Professional | $2,089.30 | $2,089.30 | $2,089.30 | |
HMSA
| Professional | $1,819.70 | $2,137.96 | $2,290.87 | |
Kaiser Permanente
| Professional | $1,905.46 | $2,089.30 | $2,630.27 | |
United
| Professional | $562.34 | $1,122.02 | $2,089.30 |