| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $618.75 | $701.25 | $900.00 | |
Cigna
| Professional | $900.00 | $900.00 | $900.00 | |
HMSA
| Professional | $667.54 | $785.34 | $937.50 | |
Kaiser Permanente
| Professional | $750.00 | $900.00 | $1,125.00 | |
United
| Professional | $315.00 | $900.00 | $1,125.00 |