| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $3.99 | $4.82 | $6.94 | |
Cigna
| Facility | $10.39 | $10.39 | $10.39 | |
Cigna
| Professional | $6.87 | $6.87 | $11.91 | |
HMSA
| Professional | $22.50 | $23.56 | $23.56 | |
Kaiser Permanente
| Professional | $670.00 | $670.00 | $670.00 | |
United
| Professional | $3.33 | $5.14 | $15.48 |