| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $64.57 | $64.57 | $70.79 | |
Cigna
| Professional | $66.07 | $66.07 | $66.07 | |
HMSA
| Professional | $95.50 | $95.50 | $95.50 | |
Kaiser Permanente
| Professional | $72.44 | $79.43 | $91.20 | |
United
| Professional | $66.07 | $97.72 | $147.91 |