| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.70 | $63.10 | $77.62 | |
Aetna
| Professional | $34.67 | $50.12 | $61.66 | |
Cigna
| Professional | $77.62 | $77.62 | $77.62 | |
HMSA
| Professional | $64.57 | $75.86 | $81.28 | |
Kaiser Permanente
| Professional | $64.57 | $77.62 | $97.72 | |
United
| Professional | $26.92 | $64.57 | $97.72 |