| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.90 | $46.77 | $56.23 | |
Aetna
| Professional | $25.12 | $39.81 | $58.88 | |
Cigna
| Professional | $56.23 | $56.23 | $56.23 | |
HMSA
| Professional | $10.96 | $10.96 | $10.96 | |
Kaiser Permanente
| Professional | $51.29 | $56.23 | $70.79 | |
United
| Professional | $23.44 | $46.77 | $70.79 |