| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $99.59 | $112.87 | $144.86 | |
Cigna
| Professional | $144.86 | $144.86 | $144.86 | |
HMSA
| Professional | $207.90 | $228.69 | $285.86 | |
Kaiser Permanente
| Professional | $120.72 | $144.86 | $181.08 | |
United
| Professional | $50.70 | $144.86 | $234.33 |