| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.10 | $17.10 | $21.95 | |
Aetna
| Professional | $16.41 | $16.41 | $16.41 | |
HMSA
| Professional | $23.23 | $29.20 | $35.89 | |
Kaiser Permanente
| Professional | $18.29 | $21.95 | $27.44 | |
United
| Professional | $7.68 | $21.95 | $27.44 |