| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $585.75 | $663.85 | $852.00 | |
Aetna
| Professional | $376.30 | $376.30 | $376.30 | |
HMSA
| Professional | $669.11 | $802.30 | $887.50 | |
Kaiser Permanente
| Professional | $781.00 | $852.00 | $994.00 | |
United
| Professional | $710.00 | $852.00 | $1,065.00 |