| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.88 | $21.88 | $33.11 | |
Cigna
| Facility | $33.11 | $33.11 | $33.11 | |
Cigna
| Professional | $23.44 | $27.54 | $45.71 | |
HMSA
| Professional | $42.66 | $44.67 | $56.23 | |
Kaiser Permanente
| Professional | $3.02 | $29.51 | $58.88 | |
United
| Facility | $2.04 | $15.14 | $25.12 | |
United
| Professional | $16.98 | $33.11 | $45.71 |