| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $546.63 | $619.51 | $795.10 | |
Cigna
| Professional | $795.10 | $795.10 | $795.10 | |
HMSA
| Professional | $589.73 | $693.80 | $828.23 | |
Kaiser Permanente
| Professional | $662.58 | $795.10 | $993.87 | |
United
| Professional | $278.27 | $795.10 | $993.87 |