| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $74.64 | $74.64 | $74.64 | |
Cigna
| Facility | $149.97 | $149.97 | $149.97 | |
Cigna
| Professional | $56.50 | $56.50 | $56.50 | |
HMSA
| Professional | $85.54 | $89.57 | $89.57 | |
Kaiser Permanente
| Professional | $8.55 | $8.55 | $8.55 | |
United
| Professional | $69.22 | $149.97 | $237.71 |