| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.65 | $33.65 | $33.65 | |
Aetna
| Professional | $18.32 | $24.19 | $399.89 | |
Cigna
| Professional | $17.62 | $17.62 | $17.62 | |
HMSA
| Professional | $25.43 | $25.43 | $25.43 | |
Kaiser Permanente
| Professional | $19.38 | $21.14 | $24.67 | |
United
| Professional | $17.62 | $20.90 | $26.43 |