| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $524.81 | $630.96 | $758.58 | |
Aetna
| Professional | $346.74 | $549.54 | $794.33 | |
Cigna
| Professional | $758.58 | $758.58 | $758.58 | |
HMSA
| Professional | $630.96 | $741.31 | $794.33 | |
Kaiser Permanente
| Professional | $691.83 | $758.58 | $954.99 | |
United
| Professional | $316.23 | $630.96 | $954.99 |