| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $248.61 | $281.76 | $361.62 | |
Aetna
| Professional | $159.72 | $159.72 | $159.72 | |
Cigna
| Professional | $361.62 | $361.62 | $361.62 | |
HMSA
| Professional | $284.00 | $340.53 | $376.69 | |
Kaiser Permanente
| Professional | $331.49 | $361.62 | $421.89 | |
United
| Professional | $301.35 | $361.62 | $452.03 |