| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $482.54 | $546.88 | $701.88 | |
Aetna
| Professional | $310.00 | $310.00 | $310.00 | |
Cigna
| Professional | $701.88 | $701.88 | $701.88 | |
HMSA
| Professional | $551.21 | $660.94 | $731.13 | |
Kaiser Permanente
| Professional | $643.39 | $701.88 | $818.86 | |
United
| Professional | $584.90 | $701.88 | $877.35 |