| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $94.40 | $106.99 | $137.32 | |
Cigna
| Professional | $137.32 | $137.32 | $137.32 | |
HMSA
| Professional | $113.23 | $135.77 | $150.19 | |
Kaiser Permanente
| Professional | $114.43 | $137.32 | $171.65 | |
United
| Professional | $48.06 | $137.32 | $171.65 |