| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.13 | $16.98 | $20.89 | |
Aetna
| Professional | $8.91 | $12.88 | $15.85 | |
Cigna
| Professional | $20.89 | $20.89 | $20.89 | |
HMSA
| Professional | $17.38 | $20.42 | $21.38 | |
Kaiser Permanente
| Professional | $17.38 | $20.89 | $25.70 | |
United
| Professional | $7.24 | $17.38 | $25.70 |