| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $72.44 | $72.44 | $72.44 | |
Cigna
| Professional | $72.44 | $72.44 | $72.44 | |
HMSA
| Professional | $69.18 | $69.18 | $69.18 | |
Kaiser Permanente
| Professional | $81.28 | $89.13 | $102.33 | |
United
| Professional | $77.62 | $89.13 | $109.65 |