| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $577.96 | $655.02 | $840.67 | |
Aetna
| Professional | $371.30 | $371.30 | $371.30 | |
HMSA
| Professional | $660.21 | $791.63 | $875.70 | |
Kaiser Permanente
| Professional | $770.62 | $840.67 | $980.78 | |
United
| Professional | $700.56 | $840.67 | $1,050.83 |