| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $52.44 | $221.73 | $221.73 | |
Cigna
| Facility | $86.12 | $86.12 | $86.12 | |
Cigna
| Professional | $63.51 | $63.51 | $360.15 | |
HMSA
| Professional | $211.77 | $237.93 | $249.14 | |
Kaiser Permanente
| Professional | $256.74 | $280.08 | $326.76 | |
United
| Professional | $135.90 | $207.64 | $264.75 |