| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.66 | $42.66 | $61.66 | |
Aetna
| Professional | $44.67 | $44.67 | $44.67 | |
Cigna
| Professional | $26.92 | $26.92 | $26.92 | |
HMSA
| Professional | $47.86 | $56.23 | $58.88 | |
Kaiser Permanente
| Professional | $45.71 | $54.95 | $67.61 | |
United
| Professional | $26.92 | $45.71 | $67.61 |