| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $37.15 | $37.15 | $61.66 | |
Cigna
| Professional | $42.66 | $50.12 | $107.15 | |
HMSA
| Professional | $100.00 | $104.71 | $134.90 | |
Kaiser Permanente
| Professional | $53.70 | $69.18 | $138.04 | |
United
| Facility | $3.72 | $28.18 | $47.86 | |
United
| Professional | $30.90 | $53.70 | $107.15 |