| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $199.53 | $199.53 | $234.42 | |
Cigna
| Professional | $199.53 | $199.53 | $234.42 | |
HMSA
| Professional | $194.98 | $194.98 | $194.98 | |
Kaiser Permanente
| Professional | $199.53 | $239.88 | $302.00 | |
United
| Professional | $199.53 | $204.17 | $234.42 |