| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $289.30 | $289.30 | $289.30 | |
Cigna
| Professional | $128.69 | $128.69 | $447.03 | |
HMSA
| Professional | $150.00 | $150.00 | $157.07 | |
Kaiser Permanente
| Professional | $364.24 | $397.36 | $413.91 | |
United
| Professional | $259.31 | $388.97 | $447.03 |