| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $18.20 | $18.20 | $19.05 | |
Cigna
| Professional | $18.20 | $18.20 | $18.20 | |
HMSA
| Professional | $18.20 | $18.20 | $18.20 | |
Kaiser Permanente
| Professional | $19.95 | $21.88 | $25.12 | |
United
| Professional | $18.20 | $20.89 | $26.92 |