| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $30.90 | $30.90 | $52.48 | |
Cigna
| Facility | $45.71 | $45.71 | $45.71 | |
Cigna
| Professional | $36.31 | $43.65 | $63.10 | |
HMSA
| Professional | $57.54 | $60.26 | $74.13 | |
Kaiser Permanente
| Professional | $40.74 | $41.69 | $81.28 | |
United
| Facility | $3.09 | $22.91 | $41.69 | |
United
| Professional | $26.30 | $45.71 | $63.10 |