| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.14 | $60.22 | $77.29 | |
Cigna
| Professional | $77.29 | $77.29 | $77.29 | |
HMSA
| Professional | $57.32 | $67.44 | $80.51 | |
Kaiser Permanente
| Professional | $64.41 | $77.29 | $96.62 | |
United
| Professional | $27.05 | $77.29 | $96.62 |