| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $52.00 | $52.00 | $52.00 | |
Cigna
| Professional | $21.25 | $67.09 | $67.09 | |
HMSA
| Professional | $68.15 | $71.36 | $71.36 | |
Kaiser Permanente
| Professional | $85.40 | $85.40 | $85.40 | |
United
| Professional | $23.69 | $60.39 | $88.83 |