| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,698.24 | $1,698.24 | $1,698.24 | |
Aetna
| Professional | $23.99 | $23.99 | $25.70 | |
Cigna
| Professional | $24.55 | $24.55 | $24.55 | |
HMSA
| Professional | $20.42 | $20.42 | $20.42 | |
Kaiser Permanente
| Professional | $26.92 | $29.51 | $34.67 | |
United
| Professional | $22.91 | $24.55 | $37.15 |