| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $421.74 | $477.97 | $613.44 | |
Cigna
| Professional | $613.44 | $613.44 | $613.44 | |
HMSA
| Professional | $120.64 | $120.64 | $120.64 | |
Kaiser Permanente
| Professional | $511.20 | $613.44 | $766.80 | |
United
| Professional | $214.70 | $613.44 | $766.80 |