| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $104.71 | $104.71 | $114.82 | |
Cigna
| Professional | $104.71 | $104.71 | $104.71 | |
HMSA
| Professional | $151.36 | $151.36 | $151.36 | |
Kaiser Permanente
| Professional | $114.82 | $125.89 | $147.91 | |
United
| Professional | $104.71 | $158.49 | $588.84 |