| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $17.46 | $17.46 | $17.46 | |
Cigna
| Facility | $35.31 | $35.31 | $35.31 | |
Cigna
| Professional | $28.58 | $28.58 | $28.58 | |
HMSA
| Professional | $30.00 | $31.41 | $31.41 | |
Kaiser Permanente
| Professional | $3.00 | $3.00 | $3.00 | |
United
| Professional | $16.30 | $35.31 | $55.90 |