| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.66 | $51.29 | $61.66 | |
Aetna
| Professional | $41.69 | $41.69 | $41.69 | |
Cigna
| Professional | $61.66 | $61.66 | $61.66 | |
HMSA
| Professional | $53.70 | $63.10 | $67.61 | |
Kaiser Permanente
| Professional | $51.29 | $61.66 | $77.62 | |
United
| Professional | $21.38 | $44.67 | $72.44 |