| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $338.84 | $338.84 | $467.74 | |
Cigna
| Facility | $524.81 | $524.81 | $524.81 | |
Cigna
| Professional | $302.00 | $363.08 | $630.96 | |
HMSA
| Professional | $630.96 | $660.69 | $794.33 | |
Kaiser Permanente
| Professional | $416.87 | $524.81 | $831.76 | |
United
| Facility | $27.54 | $204.17 | $316.23 | |
United
| Professional | $234.42 | $524.81 | $630.96 |