| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.88 | $21.88 | $23.99 | |
Cigna
| Professional | $21.88 | $21.88 | $21.88 | |
HMSA
| Professional | $19.95 | $19.95 | $19.95 | |
Kaiser Permanente
| Professional | $24.55 | $26.30 | $30.90 | |
United
| Professional | $21.88 | $25.12 | $33.11 |