| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $913.72 | $913.72 | $913.72 | |
Cigna
| Facility | $913.73 | $913.73 | $913.73 | |
Cigna
| Professional | $508.96 | $508.96 | $508.96 | |
HMSA
| Professional | $717.81 | $717.81 | $717.81 | |
Kaiser Permanente
| Professional | $559.86 | $610.76 | $712.55 | |
United
| Professional | $508.96 | $589.98 | $763.44 |