| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $134.62 | $134.62 | $134.62 | |
Cigna
| Facility | $210.64 | $210.64 | $210.64 | |
Cigna
| Professional | $228.90 | $228.90 | $228.90 | |
HMSA
| Professional | $247.21 | $247.21 | $247.21 | |
Kaiser Permanente
| Professional | $255.29 | $255.29 | $255.29 | |
United
| Professional | $175.81 | $210.64 | $304.58 |