| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $389.05 | $389.05 | $426.58 | |
Cigna
| Professional | $389.05 | $389.05 | $389.05 | |
HMSA
| Professional | $380.19 | $380.19 | $380.19 | |
Kaiser Permanente
| Professional | $426.58 | $467.74 | $549.54 | |
United
| Professional | $389.05 | $457.09 | $588.84 |