| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $569.49 | $645.41 | $828.35 | |
Aetna
| Professional | $365.85 | $365.85 | $365.85 | |
Cigna
| Professional | $828.35 | $828.35 | $828.35 | |
HMSA
| Professional | $650.54 | $780.03 | $862.86 | |
Kaiser Permanente
| Professional | $759.32 | $828.35 | $966.41 | |
United
| Professional | $690.29 | $828.35 | $1,035.44 |