| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.78 | $43.95 | $56.40 | |
Aetna
| Professional | $24.91 | $24.91 | $24.91 | |
Cigna
| Professional | $56.40 | $56.40 | $56.40 | |
HMSA
| Professional | $11.09 | $11.09 | $11.09 | |
Kaiser Permanente
| Professional | $51.70 | $56.40 | $65.80 | |
United
| Professional | $47.00 | $56.40 | $70.50 |