| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $61.66 | $75.86 | $100.00 | |
Cigna
| Facility | $81.28 | $81.28 | $112.20 | |
Cigna
| Professional | $81.28 | $125.89 | $177.83 | |
HMSA
| Professional | $144.54 | $144.54 | $151.36 | |
Kaiser Permanente
| Professional | $87.10 | $144.54 | $165.96 | |
United
| Facility | $64.57 | $81.28 | $83.18 | |
United
| Professional | $75.86 | $109.65 | $158.49 |