| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $398.11 | $478.63 | $575.44 | |
Aetna
| Professional | $112.20 | $380.19 | $467.74 | |
Cigna
| Professional | $575.44 | $575.44 | $575.44 | |
HMSA
| Professional | $478.63 | $575.44 | $602.56 | |
Kaiser Permanente
| Professional | $524.81 | $575.44 | $724.44 | |
United
| Professional | $104.71 | $208.93 | $575.44 |