| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.95 | $22.39 | $33.11 | |
Aetna
| Professional | $18.20 | $22.91 | $36.31 | |
HMSA
| Professional | $54.95 | $57.54 | $69.18 | |
Kaiser Permanente
| Professional | $23.99 | $28.84 | $36.31 | |
United
| Professional | $10.00 | $33.11 | $36.31 |