| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $35.83 | $40.61 | $52.12 | |
Aetna
| Professional | $20.04 | $20.04 | $20.04 | |
Cigna
| Professional | $52.12 | $52.12 | $52.12 | |
HMSA
| Professional | $40.93 | $49.08 | $54.29 | |
Kaiser Permanente
| Professional | $47.77 | $52.12 | $60.80 | |
United
| Professional | $52.12 | $65.15 | $87.26 |