| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,884.03 | $3,467.37 | $4,168.69 | |
Aetna
| Professional | $1,778.28 | $1,778.28 | $3,019.95 | |
Cigna
| Professional | $4,168.69 | $4,168.69 | $4,168.69 | |
HMSA
| Professional | $3,019.95 | $3,019.95 | $3,715.35 | |
Kaiser Permanente
| Professional | $3,890.45 | $4,168.69 | $5,248.07 | |
United
| Professional | $1,737.80 | $3,467.37 | $5,248.07 |