| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.56 | $50.56 | $50.56 | |
Cigna
| Facility | $101.37 | $101.37 | $101.37 | |
Cigna
| Professional | $37.95 | $37.95 | $37.95 | |
HMSA
| Professional | $2.34 | $2.45 | $2.45 | |
Kaiser Permanente
| Professional | $0.23 | $0.23 | $0.23 | |
United
| Professional | $46.78 | $101.37 | $160.66 |