| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.58 | $113.99 | $146.29 | |
Aetna
| Professional | $79.78 | $79.78 | $79.78 | |
Cigna
| Professional | $146.29 | $146.29 | $146.29 | |
HMSA
| Professional | $167.58 | $197.74 | $230.43 | |
Kaiser Permanente
| Professional | $134.10 | $146.29 | $170.67 | |
United
| Professional | $146.29 | $150.52 | $182.87 |