| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $51.29 | $51.29 | $57.54 | |
Cigna
| Professional | $51.29 | $51.29 | $51.29 | |
HMSA
| Professional | $50.12 | $50.12 | $50.12 | |
Kaiser Permanente
| Professional | $57.54 | $61.66 | $72.44 | |
United
| Professional | $46.77 | $51.29 | $77.62 |