| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.67 | $133.36 | $171.16 | |
Aetna
| Professional | $75.59 | $75.59 | $75.59 | |
Cigna
| Professional | $171.16 | $171.16 | $171.16 | |
HMSA
| Professional | $169.23 | $202.91 | $224.46 | |
Kaiser Permanente
| Professional | $156.88 | $171.16 | $199.68 | |
United
| Professional | $142.63 | $171.16 | $213.95 |