| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $524.81 | $524.81 | $575.44 | |
Cigna
| Professional | $524.81 | $524.81 | $524.81 | |
HMSA
| Professional | $758.58 | $758.58 | $758.58 | |
Kaiser Permanente
| Professional | $575.44 | $630.96 | $741.31 | |
United
| Professional | $363.08 | $524.81 | $794.33 |