| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.09 | $78.31 | $100.51 | |
Cigna
| Professional | $100.51 | $100.51 | $100.51 | |
HMSA
| Professional | $74.55 | $87.71 | $104.70 | |
Kaiser Permanente
| Professional | $83.76 | $100.51 | $125.64 | |
United
| Professional | $35.18 | $100.51 | $125.64 |