| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $436.52 | $524.81 | $630.96 | |
Aetna
| Professional | $288.40 | $457.09 | $660.69 | |
Cigna
| Professional | $630.96 | $630.96 | $630.96 | |
HMSA
| Professional | $524.81 | $616.60 | $660.69 | |
Kaiser Permanente
| Professional | $575.44 | $630.96 | $794.33 | |
United
| Professional | $263.03 | $524.81 | $794.33 |