| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.47 | $21.47 | $21.47 | |
Cigna
| Facility | $43.21 | $43.21 | $43.21 | |
Cigna
| Professional | $30.29 | $30.29 | $30.29 | |
HMSA
| Professional | $20.00 | $20.94 | $20.94 | |
Kaiser Permanente
| Professional | $2.00 | $2.00 | $2.00 | |
United
| Professional | $19.94 | $40.33 | $68.50 |