| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.21 | $31.97 | $41.03 | |
Cigna
| Professional | $41.03 | $41.03 | $41.03 | |
HMSA
| Professional | $50.89 | $63.72 | $74.25 | |
Kaiser Permanente
| Professional | $34.19 | $41.03 | $51.29 | |
United
| Professional | $14.36 | $41.03 | $51.29 |