| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $426.58 | $501.19 | $616.60 | |
Aetna
| Professional | $275.42 | $398.11 | $489.78 | |
Cigna
| Professional | $616.60 | $616.60 | $616.60 | |
HMSA
| Professional | $120.23 | $120.23 | $120.23 | |
Kaiser Permanente
| Professional | $512.86 | $616.60 | $758.58 | |
United
| Professional | $213.80 | $512.86 | $758.58 |