| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.63 | $23.38 | $30.00 | |
Aetna
| Professional | $13.25 | $13.25 | $13.25 | |
Cigna
| Professional | $30.00 | $30.00 | $30.00 | |
HMSA
| Professional | $25.00 | $26.18 | $31.25 | |
Kaiser Permanente
| Professional | $27.50 | $30.00 | $35.00 | |
United
| Professional | $25.00 | $37.50 | $37.50 |