| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.85 | $29.29 | $37.60 | |
Cigna
| Professional | $37.60 | $37.60 | $37.60 | |
HMSA
| Professional | $37.17 | $44.57 | $49.30 | |
Kaiser Permanente
| Professional | $31.33 | $37.60 | $47.00 | |
United
| Professional | $13.16 | $37.60 | $47.00 |