| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $495.00 | $561.00 | $720.00 | |
Aetna
| Professional | $318.00 | $318.00 | $318.00 | |
Cigna
| Professional | $720.00 | $720.00 | $720.00 | |
HMSA
| Professional | $565.44 | $678.00 | $750.00 | |
Kaiser Permanente
| Professional | $660.00 | $720.00 | $840.00 | |
United
| Professional | $600.00 | $720.00 | $900.00 |