| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.00 | $104.00 | $104.00 | |
Aetna
| Professional | $55.10 | $55.10 | $60.61 | |
Cigna
| Professional | $56.42 | $56.42 | $85.13 | |
HMSA
| Professional | $71.70 | $71.70 | $75.09 | |
Kaiser Permanente
| Professional | $69.37 | $75.67 | $78.83 | |
United
| Professional | $56.50 | $84.75 | $85.13 |