| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $14.13 | $14.13 | $16.60 | |
Cigna
| Professional | $14.13 | $14.13 | $16.60 | |
HMSA
| Professional | $14.13 | $14.13 | $14.13 | |
Kaiser Permanente
| Professional | $14.13 | $16.98 | $21.38 | |
United
| Professional | $14.13 | $14.79 | $16.60 |