| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $316.23 | $380.19 | $457.09 | |
Aetna
| Professional | $104.71 | $181.97 | $331.13 | |
Cigna
| Professional | $457.09 | $457.09 | $457.09 | |
HMSA
| Professional | $380.19 | $457.09 | $478.63 | |
Kaiser Permanente
| Professional | $426.58 | $457.09 | $575.44 | |
United
| Professional | $95.50 | $190.55 | $457.09 |