| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $27.93 | $31.66 | $40.63 | |
Aetna
| Professional | $17.95 | $17.95 | $17.95 | |
Cigna
| Professional | $40.63 | $40.63 | $40.63 | |
HMSA
| Professional | $10.11 | $10.11 | $10.11 | |
Kaiser Permanente
| Professional | $37.25 | $40.63 | $47.40 | |
United
| Professional | $33.86 | $40.63 | $50.79 |