| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $397.77 | $450.80 | $578.57 | |
Aetna
| Professional | $109.87 | $109.87 | $109.87 | |
Cigna
| Professional | $578.57 | $578.57 | $578.57 | |
HMSA
| Professional | $454.37 | $544.82 | $602.67 | |
Kaiser Permanente
| Professional | $530.35 | $578.57 | $675.00 | |
United
| Professional | $207.31 | $310.97 | $578.57 |