| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $649.40 | $735.99 | $944.58 | |
Aetna
| Professional | $417.19 | $417.19 | $417.19 | |
Cigna
| Professional | $944.58 | $944.58 | $944.58 | |
HMSA
| Professional | $185.77 | $185.77 | $185.77 | |
Kaiser Permanente
| Professional | $865.87 | $944.58 | $1,102.01 | |
United
| Professional | $787.15 | $944.58 | $1,180.73 |