| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $588.84 | $707.95 | $870.96 | |
Aetna
| Professional | $389.05 | $616.60 | $912.01 | |
Cigna
| Professional | $870.96 | $870.96 | $870.96 | |
HMSA
| Professional | $724.44 | $758.58 | $891.25 | |
Kaiser Permanente
| Professional | $794.33 | $870.96 | $1,071.52 | |
United
| Professional | $363.08 | $724.44 | $1,071.52 |