| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $401.40 | $454.91 | $583.85 | |
Aetna
| Professional | $257.87 | $257.87 | $257.87 | |
Cigna
| Professional | $583.85 | $583.85 | $583.85 | |
HMSA
| Professional | $486.54 | $509.47 | $608.17 | |
Kaiser Permanente
| Professional | $535.19 | $583.85 | $681.16 | |
United
| Professional | $486.54 | $583.85 | $729.81 |