| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $22.91 | $22.91 | $41.69 | |
Cigna
| Professional | $22.91 | $22.91 | $28.18 | |
HMSA
| Professional | $28.84 | $28.84 | $28.84 | |
Kaiser Permanente
| Professional | $22.91 | $27.54 | $34.67 | |
United
| Professional | $22.91 | $23.99 | $75.86 |