| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $85.11 | $87.10 | $147.91 | |
Cigna
| Professional | $87.10 | $87.10 | $100.00 | |
HMSA
| Professional | $85.11 | $85.11 | $85.11 | |
Kaiser Permanente
| Professional | $87.10 | $104.71 | $128.82 | |
United
| Professional | $87.10 | $89.13 | $100.00 |