| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,310.30 | $4,885.00 | $6,269.52 | |
Aetna
| Professional | $2,769.04 | $2,769.04 | $2,769.04 | |
Cigna
| Professional | $6,269.52 | $6,269.52 | $6,269.52 | |
HMSA
| Professional | $5,224.60 | $5,470.78 | $6,530.75 | |
Kaiser Permanente
| Professional | $5,747.06 | $6,269.52 | $7,314.44 | |
United
| Professional | $5,224.60 | $6,269.52 | $7,836.90 |