| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $575.44 | $575.44 | $630.96 | |
Cigna
| Professional | $575.44 | $575.44 | $575.44 | |
HMSA
| Professional | $831.76 | $831.76 | $831.76 | |
Kaiser Permanente
| Professional | $630.96 | $691.83 | $812.83 | |
United
| Professional | $575.44 | $645.65 | $870.96 |