| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $31.50 | $31.50 | $31.50 | |
Cigna
| Facility | $63.15 | $63.15 | $63.15 | |
Cigna
| Professional | $49.68 | $49.68 | $49.68 | |
HMSA
| Professional | $61.36 | $64.25 | $64.25 | |
Kaiser Permanente
| Professional | $6.13 | $6.13 | $6.13 | |
United
| Professional | $29.14 | $63.15 | $100.21 |