| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.57 | $77.62 | $95.50 | |
Aetna
| Professional | $42.66 | $67.61 | $100.00 | |
Cigna
| Professional | $95.50 | $95.50 | $95.50 | |
HMSA
| Professional | $79.43 | $79.43 | $83.18 | |
Kaiser Permanente
| Professional | $87.10 | $95.50 | $117.49 | |
United
| Professional | $39.81 | $79.43 | $117.49 |