| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $23.99 | $23.99 | $38.02 | |
Cigna
| Facility | $50.12 | $50.12 | $50.12 | |
Cigna
| Professional | $25.70 | $28.84 | $61.66 | |
HMSA
| Professional | $57.54 | $67.61 | $77.62 | |
Kaiser Permanente
| Professional | $4.47 | $39.81 | $81.28 | |
United
| Facility | $2.29 | $16.60 | $28.18 | |
United
| Professional | $17.78 | $42.66 | $61.66 |