| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $204.17 | $245.47 | $295.12 | |
Aetna
| Professional | $134.90 | $190.55 | $239.88 | |
Cigna
| Professional | $295.12 | $295.12 | $295.12 | |
HMSA
| Professional | $263.03 | $316.23 | $331.13 | |
Kaiser Permanente
| Professional | $245.47 | $295.12 | $371.54 | |
United
| Professional | $104.71 | $245.47 | $371.54 |