| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $152.79 | $173.16 | $222.24 | |
Aetna
| Professional | $98.16 | $98.16 | $98.16 | |
Cigna
| Professional | $222.24 | $222.24 | $222.24 | |
HMSA
| Professional | $185.20 | $193.93 | $231.50 | |
Kaiser Permanente
| Professional | $203.72 | $222.24 | $259.27 | |
United
| Professional | $185.20 | $222.24 | $277.80 |