| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $37.15 | $47.86 | $69.18 | |
Cigna
| Professional | $38.90 | $58.88 | $85.11 | |
HMSA
| Professional | $61.66 | $69.18 | $81.28 | |
Kaiser Permanente
| Professional | $37.15 | $56.23 | $66.07 | |
United
| Facility | $1,071.52 | $1,071.52 | $1,071.52 | |
United
| Professional | $47.86 | $64.57 | $128.82 |