| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $216.74 | $245.64 | $315.26 | |
Aetna
| Professional | $139.24 | $139.24 | $139.24 | |
Cigna
| Professional | $315.26 | $315.26 | $315.26 | |
HMSA
| Professional | $247.59 | $296.87 | $328.40 | |
Kaiser Permanente
| Professional | $288.99 | $315.26 | $367.81 | |
United
| Professional | $262.72 | $315.26 | $394.08 |