| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $300.33 | $300.33 | $300.33 | |
Cigna
| Facility | $469.48 | $469.48 | $469.48 | |
Cigna
| Professional | $510.69 | $510.69 | $510.69 | |
HMSA
| Professional | $569.58 | $596.41 | $596.41 | |
Kaiser Permanente
| Professional | $569.58 | $569.58 | $569.58 | |
United
| Professional | $390.57 | $469.48 | $679.56 |