| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.42 | $24.55 | $30.20 | |
Aetna
| Professional | $12.88 | $20.89 | $30.90 | |
Cigna
| Professional | $30.20 | $30.20 | $30.20 | |
HMSA
| Professional | $25.12 | $26.30 | $30.90 | |
Kaiser Permanente
| Professional | $27.54 | $30.20 | $37.15 | |
United
| Professional | $12.59 | $25.12 | $37.15 |