| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.96 | $60.02 | $77.03 | |
Cigna
| Professional | $77.03 | $77.03 | $77.03 | |
HMSA
| Professional | $57.13 | $67.20 | $80.23 | |
Kaiser Permanente
| Professional | $64.19 | $77.03 | $96.29 | |
United
| Professional | $26.96 | $77.03 | $96.29 |